Document Type
Article
Publication Date
4-21-2025
Abstract
Background: Cardiopulmonary bypass (CPB) is a critical component in cardiac surgery, enabling surgeons to perform complex procedures while maintaining systemic perfusion, oxygenation, and a bloodless field. Despite advancements in the CPB circuit design, prime solutions, and management strategies, complications such as inflammatory responses, coagulopathy, and organ dysfunction remain common. Therefore, identifying best practices that optimize perfusion parameters and improve patient outcomes is paramount.
Despite the best efforts, every patient has an inflammatory response to CPB, and it is not unusual to receive a blood product transfusion during CPB. A leukocyte depletion filter (LDF) is a device used in blood transfusions to minimize the reinfusion of white blood cells (leukocytes). Activated leukocytes and inflammatory mediators create an unwanted inflammatory response, however, these filters are not widely used during CPB. The rationale of some perfusionists may be due to the integrated filters in the cardiotomy and reservoir of the CPB circuit, but should a LDF be added when transfusing blood products on CPB?
Objectives: The study aim was to perform a scoping review on using a LDF for blood product administration during CPB and the benefits it may provide.
Design: This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Three online databases were used to identify articles published between 2000-2025, from which 43 published articles were selected for review. These articles were from the United States, Netherlands, Germany, Greece, China, United Kingdom, Italy, and Finland.
Results: The use of a LDF is a subject that remains unclear with a variety of data. None of the articles reviewed during this scoping review discussed the use and benefits of LDF for blood product administration during CPB.
Conclusions: While various data are available on LDF, CPB, and/or blood transfusions, the scholarly community lacks research and evidence on the benefits of using LDF for blood transfusions during CPB. Practices are inconsistent due to the lack of evidence necessary to support this topic. This scoping review indicates the need for future studies to standardize best practices in cardiopulmonary perfusion.
Recommended Citation
Helms, Amber J., "The Benefits of Leukocyte Depletion Filters for Blood Product Administration during Cardiopulmonary Bypass: A Scoping Review" (2025). Student Works. 7.
https://digitalcollections.lipscomb.edu/cper_student/7