Systemic inflammatory responses to cardiopulmonary bypass: a pilot study of the effects of pentoxifylline.
The potential of pentoxifylline (PTX) to modify systemic inflammatory responses and lung injury following cardiopulmonary bypass (CPB) was studied in 20 patients undergoing elective coronary artery surgery. Ten control patients were compared with ten patients who received a PTX infusion of 1 mg kg-1 h-1 during surgery. Intra-vascular pulmonary leukocyte sequestration was observed in neither group following discontinuation of CPB. Plasma elastase-alpha-1-antiprotease complex rose three-fold from baseline in both groups to peak at sternal closure. No significant plasma interleukin-1 (IL-1) response was detected. Plasma interleukin-6 (IL-6) rose in both groups from baseline to peak 4 h postoperatively. There was no correlation between plasma levels of elastase complex, IL-1 or IL-6 and impairment of postoperative oxygenation. CPB was associated with significant postoperative hypoxaemia and systemic release of neutrophil elastase and IL-6 but PTX, at the given dose, did not abrogate these responses.
Butler
J
J
Department of Cardiothoracic Surgery, Oxford Heart Centre, U.K.
Baigrie
R J
RJ
Parker
D
D
Chong
J L
JL
Shale
D J
DJ
Pillai
R
R
Westaby
S
S
Rocker
G M
GM
D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D002465:Cell Movement; D001026:Coronary Artery Bypass / Q000009:adverse effects; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000209:etiology; D007262:Infusions, Intravenous; D007375:Interleukin-1 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D019272:Leukocyte Elastase / Q000032:analysis / Q000097:blood; D007962:Leukocytes / Q000473:pathology; D008168:Lung / Q000098:blood supply / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000201:enzymology; D010101:Oxygen Consumption; D010431:Pentoxifylline / Q000008:administration & dosage / Q000627:therapeutic use*; D010726:Phosphodiesterase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D010865:Pilot Projects; D012128:Respiratory Distress Syndrome / Q000517:prevention & control; D018746:Systemic Inflammatory Response Syndrome / Q000517:prevention & control*; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000515:alpha 1-Antitrypsin / Q000032:analysis
D007375:Interleukin-1; D015850:Interleukin-6; D010726:Phosphodiesterase Inhibitors; D014665:Vasodilator Agents; D000515:alpha 1-Antitrypsin; C037741:alpha 1-antitrypsin-leukocyte elastase complex; D019272:Leukocyte Elastase; D010431:Pentoxifylline