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The use of leucocyte-depleting and conventional arterial line filters in cardiac surgery: a systematic review of clinical studies

Unit of Health Psychology, Department of Psychiatry and Behavioural Science, Royal Free and University College Medical School, London

J A Stygall

Unit of Health Psychology, Department of Psychiatry and Behavioural Science, Royal Free and University College Medical School, London

S P Newman

Unit of Health Psychology, Department of Psychiatry and Behavioural Science, Royal Free and University College Medical School, London

M JG Harrison

Clinical Neurology, UCL Hospital and Medical School, London

Although various forms of arterial line filter have been available for use during cardiopulmonary bypass (CPB) for 30 years, their use is not universal. The aim of this review was to seek evidence of the clinical benefit of using conventional or leucocyte-depleting arterial line filters during bypass. A literature search revealed 28 relevant clinical studies. Despite the wide variety of patient populations, types of filter and outcome measures utilized in studies, a few conclusions are possible. Whereas conventional filtration has the definite effect of reducing neuropsychological deficit post-CPB, the results of studies using the leucocyte-depleting filter are less clear cut. Leucocyte-depleting filters have potential for reducing inflammatory mediated heart and lung injury, however it is recommended that any additional benefit of leucocyte-depleting filters over conventional filters should be further tested by randomized controlled trials of sufficient size.

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