Methylprednisolone and full-dose aprotinin reduce reperfusion injury after cardiopulmonary bypass.
OBJECTIVE
To compare the effects of low- and full-dose aprotinin to methylprednisolone (MPS) in reducing cardiopulmonary bypass (CPB)-induced interleukin-6 (IL-6) release.


METHODS
Prospective, randomized, blinded study.


METHODS
Cytokine Laboratory, pharmacology department, in a university teaching hospital.


METHODS
Forty adult male human patients scheduled for myocardial revascularization were divided into four groups (n = 10): (1) control; (2) MPS, 1 g IV before CPB; (3) aprotinin-low-dose protocol; and (4) aprotinin-full-dose protocol.


RESULTS
Plasma levels of IL-6 were measured at baseline and 1 and 24 hours after CPB by enzyme-linked immunosorbent assay technique. Group 1 demonstrated a significant (p < 0.05) increase in IL-6 at 1 and 24 hours post-CPB. Groups 2 and 4 demonstrated significant (p < 0.05) reduction of IL-6 at 1 (group 2 only) and 24 (groups 2 and 4) hours post-CPB when compared with group 1 at the same time periods.


CONCLUSIONS
These results demonstrate that MPS, 1 g before CPB, and full-dose aprotinin, but not half-dose aprotinin, achieve significant reduction in IL-6 release after CPB. These results further suggest that MPS and full-dose aprotinin may reduce reperfusion injury after CPB.
Diego
R P
RP
Department of Anesthesiology, University of Nebraska Medical Center, Omaha 68198-4455, USA.
Mihalakakos
P J
PJ
Hexum
T D
TD
Hill
G E
GE
D000368:Aged; D007611:Aprotinin / Q000008:administration & dosage*; D002315:Cardiopulmonary Bypass; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage*; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D015427:Reperfusion Injury / Q000517:prevention & control*
D005938:Glucocorticoids; D015850:Interleukin-6; D007611:Aprotinin; D008775:Methylprednisolone