Equivalence of the acute cytokine surge and myocardial injury after coronary artery bypass grafting with and without a novel extracorporeal circulation system.
Cardiopulmonary bypass (CPB) contributes to a morbidity-inducing systemic inflammatory response after cardiac surgery. We compared this response in patients receiving coronary artery bypass grafting (CABG) with (CPB group; n = 7) or without (off-pump group; n = 8) the Minimal Extracorporeal Circulation (MECC) system. Serum concentrations of tumour necrosis factor (TNF)-alpha, soluble TNF receptors, pro- and anti-inflammatory interleukins (ILs) and other myocardial injury markers were measured after anaesthetic induction, at 1 h, 4 h and 24 h after completing all anastomoses or serially. Soluble TNF receptor type I (sTNFRI) and IL-8 peaked early after CABG in both groups and did not decline. Serum sTNFRI was significantly higher in the CPB compared with the off-pump group at 1 h, whereas IL-8 was significantly lower in the CPB group throughout. The MECC system, therefore, produces an equivalent acute cytokine response and degree of myocardial injury to off-pump CABG, and may be useful when CABG cannot be performed without CPB.
Murakami
T
T
Division of Cardiovascular Surgery, National Hospital Organization, Iwakuni Medical Centre, Iwakuni, Japan.
Iwagaki
H
H
Saito
S
S
Ohtani
S
S
Kuroki
K
K
Kuinose
M
M
Tanaka
N
N
Tanemoto
K
K
D000368:Aged; D001026:Coronary Artery Bypass / Q000379:methods*; D016207:Cytokines / Q000096:biosynthesis* / Q000097:blood; D005112:Extracorporeal Circulation; D006801:Humans; D007249:Inflammation; D016209:Interleukin-8 / Q000097:blood; D007378:Interleukins / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000378:metabolism; D047889:Receptors, Tumor Necrosis Factor, Type II / Q000096:biosynthesis; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D016207:Cytokines; D016209:Interleukin-8; D007378:Interleukins; D047889:Receptors, Tumor Necrosis Factor, Type II; D014409:Tumor Necrosis Factor-alpha