title: The effects of propofol on neutrophil function, lipid peroxidation and inflammatory response during elective coronary artery bypass grafting in patients with impaired ventricular function.
abstract: BACKGROUND
  Coronary artery bypass grafting (CABG) with cardiopulmonary bypass elicits a potent reperfusion injury and inflammatory response, more intense in patients with impaired myocardial function. Propofol has antioxidant properties which may attenuate such a response.
  
  
  METHODS
  In total, 27 patients with impaired left ventricular function undergoing CABG were randomly allocated to receive either target-controlled infusion propofol (P) or saline (S) immediately before aortic cross-clamp release until 4 h after reperfusion. Troponin-I, Urinary 8-epi PGF-2alpha isoprostane, coronary sinus and systemic malondialdehyde concentrations, Interleukin-6 (IL-6), -8 and -10 concentrations and leucocytes function studies (neutrophil respiratory burst, phagocytosis, CD-11b and CD-18 expression) were measured.
  
  
  RESULTS
  Propofol decreased MDA coronary sinus concentration at 1, 3 and 5 min after reperfusion (P<0.01); 60 min after reperfusion a significant difference between the two groups in systemic MDA concentrations was also seen. IL-6 concentration increases were significantly greater in Group S than Group P, 4 h after reperfusion [1118 (1333) pg ml(-1) vs 228 (105) pg ml(-1), P<0.01]. Serum IL-8 concentrations did not increase significantly in either group. Compared with baseline values IL-10 concentrations decreased after reperfusion but the values were higher in the propofol group than in the control group [22 (16) vs 11 (4) pg ml(-1), P<0.05]. No difference in leucocyte function or urinary isoprostane concentrations was demonstrated.
  
  
  CONCLUSIONS
  Propofol attenuates free-radical-mediated lipid peroxidation and systemic inflammation in patients with impaired myocardial function undergoing CABG.
authors.affiliation: Department of Anaesthesia and Intensive Care Medicine, Cork University/Mercy Hospitals and University College Cork, Cork City, Ireland. mascor@bigpond.net.au
authors.forename: T B
authors.initials: TB
authors.lastname: Corcoran
authors.forename: A
authors.initials: A
authors.lastname: Engel
authors.forename: H
authors.initials: H
authors.lastname: Sakamoto
authors.forename: A
authors.initials: A
authors.lastname: O'Shea
authors.forename: S
authors.initials: S
authors.lastname: O'Callaghan-Enright
authors.forename: G D
authors.initials: GD
authors.lastname: Shorten
mesh_terms: D000368:Aged; D018686:Anesthetics, Intravenous / Q000494:pharmacology*; D001026:Coronary Artery Bypass; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D007378:Interleukins / Q000097:blood; D015227:Lipid Peroxidation / Q000187:drug effects*; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D008875:Middle Aged; D015428:Myocardial Reperfusion Injury / Q000517:prevention & control; D009504:Neutrophils / Q000187:drug effects* / Q000502:physiology; D015742:Propofol / Q000494:pharmacology*; D016897:Respiratory Burst / Q000187:drug effects; D018487:Ventricular Dysfunction, Left / Q000150:complications
chemical_list: D018686:Anesthetics, Intravenous; D018836:Inflammation Mediators; D007378:Interleukins; D008315:Malondialdehyde; D015742:Propofol