Interleukin-6 enhancement after direct autologous retransfusion of shed thoracic blood does not influence haemodynamic stability following coronary artery bypass grafting.
BACKGROUND
Direct autologous retransfusion of shed thoracic blood is carried out to reduce homologous transfusion after cardiac surgery, but it contains high concentrations of inflammatory mediators. The purpose of the study was to investigate whether retransfusion of shed thoracic blood induces plasma interleukin-6 (IL-6) expression and influences haemodynamics.


METHODS
Following uncomplicated coronary artery bypass graft surgery, forty-four patients were randomised in case postoperative blood loss via thoracic drains exceeded 350 ml. The course of plasma IL-6 levels and haemodynamics including cardiac output, extravascular lung water and intrathoracic blood volume were investigated prior to (T0), 30 minutes (T1), 1 (T2), 3 (T3) and 12 hours (T4) after retransfusion of 350 ml shed blood in comparison to 350 ml saline.


RESULTS
Plasma IL-6 levels at T1 (1892 +/- 202 vs. 485 +/- 30 pg/ml) and T2 (1059 +/- 119 vs. 413 +/- 30 pg/ml) were significantly higher in the verum group (n = 20) compared to controls (n = 24) ( P < 0.01). Severe haemodynamic side effects were not detected.


CONCLUSIONS
This study found significantly elevated plasma IL-6 levels following direct autologous retransfusion of shed thoracic blood but failed to show severe adverse effects affecting haemodynamic stability.
Schroeder
S
S
Department of Anaesthesiology and Intensive Care Medicine, Westküstenklinikum Heide, Heide, Germany.
von Spiegel
T
T
Stuber
F
F
Hoeft
A
A
Preusse
C J
CJ
Welz
A
A
Kampe
S
S
Lier
H
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D001804:Blood Transfusion, Autologous; D001810:Blood Volume; D001831:Body Temperature; D002302:Cardiac Output; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000097:blood / Q000503:physiopathology* / Q000601:surgery*; D015633:Extravascular Lung Water; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D012720:Severity of Illness Index; D013909:Thorax / Q000098:blood supply*; D013997:Time Factors; D016896:Treatment Outcome
D015415:Biomarkers; D018836:Inflammation Mediators; D015850:Interleukin-6