title: Preoperative oral administration of pentoxifylline ameliorates respiratory index after cardiopulmonary bypass through decreased production of IL-6.
abstract: Activation of inflammatory response during cardiopulmonary bypass (CPB) may lead to considerable post-operative mortality. Recently, pentoxifylline (PTX), a methylxanthine derivative, has been reported to be effective in inhibiting proinflammatory cytokine production. This study aimed to determine whether or not PTX prevented CPB-induced systemic inflammatory response syndrome (SIRS) in patients undergoing cardiovascular surgery. Thirty adult patients were randomly separated into 2 experimental groups and 1 control group of 10 patients each. The experimental group received peroral PTX administration (Group 1: 600 mg/day, Group 2: 900 mg/day), while the control group did not. In Group 1 and Group 2, PTX administration was started on preoperative day 5 and continued for 5 days. Serum levels of PTX and IL-6 were measured just before and at 4 h after CPB using HPLC and ELISA, respectively. Respiratory index (RI) before and at 4 h after CPB was calculated, and serum levels of C-reactive protein (CRP) and fibrinogen on postoperative day 1 were also determined. There were no significant differences in age, body weight, sex, surgical procedures, CPB time, haemodynamics or risk factors among the 3 groups. Serum IL-6 level and RI index after CPB in Group 2 were significantly decreased compared with those in Group 1 and the control group. These results, therefore, suggested that preoperative daily administration of 900 mg/day PTX contributed to the attenuation of CPB-induced SIRS and had a beneficial effect on the postoperative course after cardiovascular surgery.
authors.affiliation: Division of Cardiovascular Surgery, National Hospital Organization, Iwakuni Clinical Center, Iwakuni, Yamaguchi 740-0041, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Otani
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kuinose
authors.forename: Takashi
authors.initials: T
authors.lastname: Murakami
authors.forename: Shinya
authors.initials: S
authors.lastname: Saito
authors.forename: Hiromi
authors.initials: H
authors.lastname: Iwagaki
authors.forename: Noriaki
authors.initials: N
authors.lastname: Tanaka
authors.forename: Kazuo
authors.initials: K
authors.lastname: Tanemoto
mesh_terms: D000328:Adult; D000368:Aged; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D006801:Humans; D015850:Interleukin-6; D008297:Male; D008875:Middle Aged; D010431:Pentoxifylline / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D010726:Phosphodiesterase Inhibitors; D011300:Preoperative Care; D012119:Respiration / Q000187:drug effects*; D018746:Systemic Inflammatory Response Syndrome / Q000188:drug therapy / Q000276:immunology / Q000517:prevention & control
chemical_list: D015850:Interleukin-6; D010726:Phosphodiesterase Inhibitors; D010431:Pentoxifylline