title: Comparison of inflammatory responses after off-pump and on-pump coronary surgery using surface modifying additives circuit.
abstract: BACKGROUND
  Cardiac surgery is followed by various degrees of inflammation, which have harmful consequences. Because of the central role of extracorporeal circulation (EC), off-pump coronary bypass surgery is deemed preferable. Do different modalities of EC challenge this view?
  
  
  METHODS
  Four groups of similar patients underwent coronary surgery: (group 1) on-pump, EC with closed surface modifying additives (SMA) circuit and no pump suckers (n = 20); (group 2) on-pump, EC with open SMA circuit and pump suckers (n = 20); (group 3) off-pump (beating heart) and heparin 3 mg/kg (n = 20); (group 4) off-pump (beating heart) and heparin 1 mg/kg (n = 20). Interleukins (IL)-6, IL-8, IL-10, myeloperoxidase, elastase, and terminal complex of the complement (TCC) were analyzed at various times: at induction (time I); after heparin (time II); after complete revascularization (time III); after protamine (time IV); and 24 hours later (time V).
  
  
  RESULTS
  The TCC was significantly higher in groups 1 and 2 at time III. The pattern of IL-6 was the same for the four groups. No significant difference in myeloperoxydase content was noted; however, elastase was significantly higher in the two EC (on-pump) groups.
  
  
  CONCLUSIONS
  Except for the complement system and elastase, on-pump surgery with SMA-coated circuits did not elicit any greater inflammatory response than off-pump surgery.
authors.affiliation: Department of Surgery, Biostatistics, University of Liège, Liège, Belgium.
authors.forename: Janine M
authors.initials: JM
authors.lastname: Quaniers
authors.forename: Julie
authors.initials: J
authors.lastname: Leruth
authors.forename: Adelin
authors.initials: A
authors.lastname: Albert
authors.forename: Raymond R
authors.initials: RR
authors.lastname: Limet
authors.forename: Jean-Olivier
authors.initials: JO
authors.lastname: Defraigne
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003167:Complement Activation / Q000502:physiology; D015938:Complement Membrane Attack Complex / Q000032:analysis; D001026:Coronary Artery Bypass / Q000009:adverse effects; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects; D005112:Extracorporeal Circulation / Q000379:methods*; D005260:Female; D006801:Humans; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009504:Neutrophils; D010196:Pancreatic Elastase / Q000097:blood; D009195:Peroxidase / Q000097:blood
chemical_list: D015938:Complement Membrane Attack Complex; D015850:Interleukin-6; D016209:Interleukin-8; D016753:Interleukin-10; D009195:Peroxidase; D010196:Pancreatic Elastase