Pump prime aprotinin fails to limit proinflammatory cytokine release after coronary artery bypass surgery.
BACKGROUND
The purpose of this study was to establish whether pump prime aprotinin could limit the cytokine responses in patients undergoing elective coronary artery bypass surgery.


METHODS
Twenty-one patients admitted for first-time elective coronary artery bypass surgery were randomized into control or aprotinin groups. Patients in the aprotinin group received 280 mg aprotinin in the pump prime. Leukocyte count, creatine kinase cardiac isoenzyme (CK-MB), cytokine production and postoperative blood loss were analyzed perioperatively and compared with preoperative values.


RESULTS
The peak level of leukocyte count was lower in the aprotinin group than in controls (9.3 +/- 0.58 vs 11.2 +/- 0.68 x 10(9)/L, p = 0.01). Interleukin (IL)-6 and IL-8 did not differ significantly between the groups throughout the study period. Plasma IL-10 levels were higher in the controls than in the aprotinin group at 5 min (49.6 +/- 24.9 vs 8.13 +/- 2.8 pg/ml, p = 0.01) after reperfusion.


CONCLUSIONS
Pump prime aprotinin fails to limit proinflammatory cytokine response in circulating blood.
Wei
M
M
Division of Cardiothoracic Surgery, Tampere University Hospital, Finland.
Kuukasjärvi
P
P
Laurikka
J
J
Pehkonen
E
E
Kaukinen
S
S
Laine
S
S
Tarkka
M
M
D000368:Aged; D007611:Aprotinin / Q000008:administration & dosage* / Q000494:pharmacology*; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001026:Coronary Artery Bypass; D016207:Cytokines / Q000096:biosynthesis* / Q000097:blood / Q000187:drug effects*; D006331:Heart Diseases / Q000378:metabolism / Q000601:surgery*; D006801:Humans; D007249:Inflammation / Q000378:metabolism; D007260:Infusion Pumps; D007378:Interleukins / Q000097:blood; D008297:Male; D008875:Middle Aged
D016207:Cytokines; D007378:Interleukins; D007611:Aprotinin