Methylprednisolone inhibits increase of interleukin 8 and 6 during open heart surgery.
It has been reported that interleukin 8 (IL-8) and interleukin 6 (IL-6) are two of the chemical mediators causing myocardial injury. It is not clear whether treatment with corticosteroids in vitro in these patients can prevent the production of interleukin 8 and 6. This prospective study was conducted to investigate whether methylprednisolone (MP) pretreatment (30 mg.kg-1 before CPB and before declamping of aorta) influenced the production of IL-8 and 6 in the peripheral circulation in 27 patients undergoing elective coronary artery bypass surgery. The IL-8 and IL-6 concentrations were measured by ELISA kit. We also studied the effect of MP pretreatment on postoperative cardiac function. Serum concentration of IL-8 in non-MP-treated patients (37 +/- 44 pg.ml-1 preoperatively) increased to 169 +/- 86 pg.ml-1 60 min after declamping of the aorta (P < 0.001). The increase was greater than the increase from 22 +/- 8.9 pg.ml-1 to 52 +/- 35 pg.ml-1 in the MP-treated patients (P < 0.01). Serum IL-6 concentration in non-MP-treated patients increased from the preoperative value of 59 +/- 30 pg.ml-1 to 436 +/- 143 pg.ml-1 60 min after declamping of the aorta (P < 0.001). The increase was greater than the increase from 36 +/- 15 pg.ml-1 to 135 +/- 85 pg.ml-1 in the MP-treated patients (P < 0.01). Furthermore, postoperative cardiac index in MP-treated patients (3.6 +/- 1.1 L.min-1.m-2) was higher than 2.3 +/- 0.8 L.min-1.m-2 of non MP-treated patients (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
Kawamura
T
T
Department of Anesthesiology, Iwate Medical University, Japan.
Inada
K
K
Okada
H
H
Okada
K
K
Wakusawa
R
R
D002302:Cardiac Output / Q000187:drug effects; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass; D003402:Creatine Kinase / Q000097:blood; D017558:Elective Surgical Procedures; D006321:Heart / Q000187:drug effects; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000037:antagonists & inhibitors* / Q000097:blood; D007527:Isoenzymes; D019272:Leukocyte Elastase; D008775:Methylprednisolone / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D015425:Myocardial Reperfusion; D010196:Pancreatic Elastase / Q000097:blood; D011292:Premedication; D011446:Prospective Studies; D011669:Pulmonary Wedge Pressure / Q000187:drug effects; D000093242:Interleukin-6 Inhibitors
D003402:Creatine Kinase; D015850:Interleukin-6; D016209:Interleukin-8; D007527:Isoenzymes; D019272:Leukocyte Elastase; D008775:Methylprednisolone; D010196:Pancreatic Elastase; D000093242:Interleukin-6 Inhibitors