CHANGES IN WBC COUNT IN FEMORAL VEIN AND RADIAL ARTERY BLOOD IN PATIENTS UNDERGOING REPAIR OF ABDOMINAL AORTIC ANEURYSM

Abstract

White blood cells (WBC) have been shown to be sequestered in ischemic tissue following reperfusion and to contribute to reperfusion injury in models of cardiac, intestinal, and skeletal muscle. Several studies have shown that the efferent venous WBC count was lower than the afferent arterial WBC count in ischemic tissue following reperfusion. As the patient undergoing abdominal aortic aneurysm repair is subject to temporary clamping of the abdominal aorta, and consequently to ischemia-reperfusion of the lower limb, we speculate that WBCs are sequestered in the lower limib such that the femoral WBC count becomes lower than the systemic WBC count. Eight patient with abdominal aortic aneurysms undergoing arterial reconstruction were subjected to a study in which WBC counts in the femoral vein and radial artrery were measured before and during the first 48 hr after declamping of the abdominal aorta. Both neutrophils and monocytes were significantly increased in both venous and arterial blood, but lymphocytes were significantly decreased after declamping of the abdominal aorta. There were no significant differences in neutrophils and lymphocytes between the femoral vein and radial artery blood. It is thought that the WBC sequestration in the lower limb was not very marked so and that the femoral venous WBC count differed from the radial arteial WBC count in patients undergoing repair of an abdominal aortic aneurysm.