title: Low tidal volume ventilation during cardiopulmonary bypass reduces postoperative chemokine serum concentrations.
abstract: BACKGROUND
  Open-heart surgery with cardiopulmonary bypass (CPB) is associated with a generalized immune response and postoperative lung dysfunction. Chemokines are involved in the pathogenesis of postoperative lung dysfunction. We investigated whether continued mechanical ventilation during CPB has an impact on chemokine serum concentrations.
  
  
  METHODS
  A total of 30 patients undergoing coronary artery bypass graft operation were randomized to either continuous ventilated group (n=15) or nonventilated group (n=15). Blood samples were drawn at the beginning and at the end of surgery and on the 5 consecutive days. Serum CCL2, CCL4, and CCL20 concentrations were measured and given as mean ± standard deviation.
  
  
  RESULTS
  Chemokine concentrations were elevated at the end of surgery in both groups. CCL2 and CCL4 levels returned to baseline on postoperative day (POD)-1 in the ventilation group and stayed elevated in the nonventilation group. CCL4 serum levels were significantly lower in ventilated-group patients on POD-1 (10.9 [39.0] vs. 153.2 [168.1]; p=0.005), POD-2 (16.8 [36.8] vs. 147.9 [165.4]; p=0.019), POD-3 (14.2 [24.0] vs. 97.9 [87.1]; p=0.005), and POD-5 (6.5 [25.0] vs. 33.6 [38.4]; p=0.045).
  
  
  CONCLUSIONS
  Continued mechanical ventilation during CPB results in reduced CCL4 concentrations on POD-1 to -5.
authors.affiliation: Department of Thoracic Surgery, Medical University Vienna, Vienna, Austria.
authors.forename: Lucian
authors.initials: L
authors.lastname: Beer
authors.affiliation: Department of Cardiac Surgery, Institute of Cardiology, Medical and Health Science Centre of University of Debrecen, Hungary.
authors.forename: Tamás
authors.initials: T
authors.lastname: Szerafin
authors.affiliation: Department of Thoracic Surgery, Medical University Vienna, Vienna, Austria.
authors.forename: Andreas
authors.initials: A
authors.lastname: Mitterbauer
authors.affiliation: Department of Cardiac Surgery, Institute of Cardiology, Medical and Health Science Centre of University of Debrecen, Hungary.
authors.forename: Tamás
authors.initials: T
authors.lastname: Debreceni
authors.affiliation: Department of Cardiac Surgery, Institute of Cardiology, Medical and Health Science Centre of University of Debrecen, Hungary.
authors.forename: Tamás
authors.initials: T
authors.lastname: Maros
authors.affiliation: Department of Anesthesiology, General Intensive Care and Pain Medicine, Medical University of Vienna, Vienna, Austria.
authors.forename: Martin
authors.initials: M
authors.lastname: Dworschak
authors.affiliation: Department of Anesthesiology, General Intensive Care and Pain Medicine, Medical University of Vienna, Vienna, Austria.
authors.forename: Georg A
authors.initials: GA
authors.lastname: Roth
authors.affiliation: Department of Thoracic Surgery, Medical University Vienna, Vienna, Austria.
authors.forename: Hendrik Jan
authors.initials: HJ
authors.lastname: Ankersmit
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001317:Austria; D015415:Biomarkers / Q000097:blood; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D018932:Chemokine CCL2 / Q000097:blood; D054418:Chemokine CCL20 / Q000097:blood; D054407:Chemokine CCL4 / Q000097:blood; D018925:Chemokines / Q000097:blood*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D015536:Down-Regulation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012121:Respiration, Artificial / Q000379:methods*; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D013990:Tidal Volume; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; C111835:CCL2 protein, human; C108355:CCL20 protein, human; C066507:CCL4 protein, human; D018932:Chemokine CCL2; D054418:Chemokine CCL20; D054407:Chemokine CCL4; D018925:Chemokines