Figure 4.

L-MOD therapy is intended to prevent the excessive inflammatory response to CPB. Because pigs with NE counts <2000 cells/μL at baseline (BL) did not demonstrate a measurable inflammatory response to CPB, analysis was performed both with (LEFT panels A-C) and without (RIGHT panels D-F) those animals. When considering all pigs, a trend for lower white blood cell (WBC) count during CPB was observed with L-MOD therapy (Panel A). WBC rebounded when L-MOD therapy was discontinued at END CPB (Group 2) but remained below the baseline (BL) average with continuation therapy (Group 3). Post-operative increases in WBC were due to a progressive increase in circulating NE, which was less for pigs in Group 3 (Panel B). However, the neutrophil responses varied widely. Among the pigs that displayed a robust inflammatory reaction to CPB, the neutrophilic response was clearly modulated during the 8 hours of venovenous LMOD therapy as significantly lower post-operative WBC were observed in Group 3 compared to Group 1 (Panel D). Total neutrophil counts were significantly lower hours 3-5 (Panel E) and a significant difference in immature neutrophil count emerged at 5h post CPB (Panel F). * p <0.05, ** p<0.01. Endpoint of upper whisker, maximum; upper edge of box, third quartile; horizontal line inside box, median; lower edge of box, first quartile; endpoint of lower whisker, minimum; Colored circles represent outlier values.