Effects of pulsatile CPB on interleukin-8 and endothelin-1 levels.
Studies on pulsatile and nonpulsatile perfusion have long been performed. However, investigators have not reached a conclusion on which is more effective. In the present study, pulsatile cardiopulmonary bypass (CPB) was investigated in terms of the effects on cytokines, endothelin, catecholamine, and pulmonary and renal functions. Twenty-four patients who underwent coronary artery bypass grafting were divided into a pulsatile CPB group and a nonpulsatile CPB group. Parameters examined were hemodynamics, interleukin-8 (IL-8), endothelin-1 (ET-1), epinephrine, norepinephrine, lactate, arterial ketone body ratio, urine volume, blood urea nitrogen, creatinine, renin activity, angiotensin-II, lactate dehydrogenase, plasma-free hemoglobin, tracheal intubation time, and respiratory index. The IL-8 at 0.5, 3, and 6 h after CPB, and ET-1 at 3, 6, 9, and 18 h after CPB were significantly lower in the pulsatile group. Both epinephrine and norepinephrine were significantly lower in the pulsatile group. The respiratory index was significantly higher in the pulsatile group. In the present study, inhibitory effects on cytokine activity, edema in pulmonary alveoli, and endothelial damage were shown in addition to the favorable effects on catecholamine level, renal function, and peripheral circulation that have already been documented.
Sezai
Akira
A
Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan. asezai@med.nihon-u.ac.jp
Shiono
Motomi
M
Nakata
Kin-ichi
K
Hata
Mitsumasa
M
Iida
Mitsuru
M
Saito
Akira
A
Hattori
Tsutomu
T
Wakui
Shinji
S
Soeda
Masao
M
Taoka
Makoto
M
Umeda
Tomofumi
T
Negishi
Nanao
N
Sezai
Yukiyasu
Y
D000368:Aged; D002315:Cardiopulmonary Bypass / Q000379:methods*; D002395:Catecholamines / Q000032:analysis; D001026:Coronary Artery Bypass / Q000379:methods*; D016207:Cytokines / Q000032:analysis / Q000276:immunology; D019332:Endothelin-1 / Q000032:analysis* / Q000276:immunology; D005260:Female; D006461:Hemolysis; D006801:Humans; D016209:Interleukin-8 / Q000032:analysis* / Q000276:immunology; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D010477:Perfusion / Q000379:methods*; D011673:Pulsatile Flow / Q000276:immunology; D012129:Respiratory Function Tests
D002395:Catecholamines; D016207:Cytokines; D019332:Endothelin-1; D016209:Interleukin-8