Effect of myocardial protection and perfusion temperature on production of cytokines and nitric oxide during cardiopulmonary bypass.
OBJECTIVE
To investigate the effects of different conditions used during cardiopulmonary bypass (CPB) surgery on accompanying production of cytokine and nitric oxide (NO).


METHODS
Patients undergoing CPB for the first time were prospectively enrolled and divided into two groups according to CPB parameters performed: i) normothermia (36.5-37 degrees C) with blood cardioplegia (NB group, n=10) and ii) hypothermia (29-31 degrees C) with crystalloid cardioplegia (HC group, n=10). Plasma samples obtained following intubation (baseline), during (5 and 30 min) and after (4 and 24 h) CPB were assayed for cytokines (ELISA) and NO metabolites (Griess reaction).


RESULTS
Peak concentrations of interleukin (IL)-6 and IL-8 were reached at 4 h post CPB in both groups, but in the HC group those levels increased earlier and persisted for longer (24 h) compared to baseline (P < 0.05). IL-10 levels also increased at 4 h compared to baseline, but only significantly so in the HC group. NO metabolites were reduced in HC group at all time points compared to baseline (P < 0.05), while no significant differences were detected in the NB group.


CONCLUSIONS
The association between increased systemic levels of cytokines and reduced NO production in the HC group suggests that different myocardial protection and/or perfusion temperature used during CPB may contribute to the extent of inflammatory response.
Tavares-Murta
Beatriz Martins
BM
Department of Biological Sciences, UFTM, Minas Gerais, MG, Brazil. bmurtafarmaco@dcb.uftm.edu.br
Cordeiro
Adriana Oliveira
AO
Murta
Eddie Fernando Candido
EF
Cunha
Fernando de Queiroz
Fde Q
Bisinotto
Flora Margarida Barra
FM
D000328:Adult; D000368:Aged; D002315:Cardiopulmonary Bypass; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006324:Heart Arrest, Induced; D006801:Humans; D007036:Hypothermia, Induced; D007378:Interleukins / Q000096:biosynthesis* / Q000097:blood; D008297:Male; D008875:Middle Aged; D015425:Myocardial Reperfusion; D009569:Nitric Oxide / Q000096:biosynthesis* / Q000097:blood; D011446:Prospective Studies; D013997:Time Factors
D007378:Interleukins; D009569:Nitric Oxide