title: The Impact of Lung Ventilation on Some Cytokines after Coronary Artery Bypass Grafting.
abstract: OBJECTIVE
  Cardiopulmonary bypass induces a systematic inflammatory response, which is partly understood by investigation of peripheral blood cytokine levels alone; the lungs may interfere with the net cytokine concentration. We investigated whether lung ventilation influences lung passage of some cytokines after coronary artery bypass grafting.
  
  
  METHODS
  In total, 47 patients undergoing coronary artery bypass grafting were enrolled, and 37 were randomized according to the ventilation technique: (1) No-ventilation group, with intubation tube detached from the ventilator; (2) low tidal volume group, with continuous low tidal volume ventilation; and (3) continuous 10 cm H2O positive airway pressure. Ten selected patients undergoing surgery without cardiopulmonary bypass served as a referral group. Representative pulmonary and radial artery blood samples were collected for the evaluation of calculated lung passage (pulmonary/radial artery) of the pro-inflammatory cytokines (interleukin 6 and interleukin 8) and the anti-inflammatory interleukin 10 immediately after induction of anesthesia (T1), 1 h after restoring ventilation/return of flow in all grafts (T2), and 20 h after restoring ventilation/return of flow in all grafts (T3).
  
  
  RESULTS
  Pulmonary/radial artery interleukin 6 and pulmonary/radial artery interleukin 8 ratios ( p = 0.001 and p = 0.05, respectively) decreased, while pulmonary/radial artery interleukin 10 ratio ( p = 0.001) increased in patients without cardiopulmonary bypass as compared with patients with cardiopulmonary bypass.
  
  
  CONCLUSIONS
  The pulmonary/radial artery equation is an innovative means for the evaluation of cytokine lung passage after coronary artery bypass grafting. The mode of lung ventilation has no impact on some cytokines after coronary artery bypass grafting in patients treated with cardiopulmonary bypass.
authors.affiliation: 1 Department of Cardiothoracic Surgery, Heart Center Co., Tampere University Hospital, University of Tampere, SDSKIR, Tampere, Finland.
authors.forename: V
authors.initials: V
authors.lastname: Toikkanen
authors.affiliation: 2 Division of Cardiac Anesthesia, Heart Center Co., Tampere University Hospital, University of Tampere, Tampere, Finland.
authors.forename: T
authors.initials: T
authors.lastname: Rinne
authors.affiliation: 3 Department of Immunopharmacology, Tampere University Hospital, University of Tampere, Tampere, Finland.
authors.forename: R
authors.initials: R
authors.lastname: Nieminen
authors.affiliation: 3 Department of Immunopharmacology, Tampere University Hospital, University of Tampere, Tampere, Finland.
authors.forename: E
authors.initials: E
authors.lastname: Moilanen
authors.affiliation: 1 Department of Cardiothoracic Surgery, Heart Center Co., Tampere University Hospital, University of Tampere, SDSKIR, Tampere, Finland.
authors.forename: J
authors.initials: J
authors.lastname: Laurikka
authors.affiliation: 2 Division of Cardiac Anesthesia, Heart Center Co., Tampere University Hospital, University of Tampere, Tampere, Finland.
authors.forename: H
authors.initials: H
authors.lastname: Porkkala
authors.affiliation: 1 Department of Cardiothoracic Surgery, Heart Center Co., Tampere University Hospital, University of Tampere, SDSKIR, Tampere, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Tarkka
authors.affiliation: 1 Department of Cardiothoracic Surgery, Heart Center Co., Tampere University Hospital, University of Tampere, SDSKIR, Tampere, Finland.
authors.forename: A
authors.initials: A
authors.lastname: Mennander
mesh_terms: D015415:Biomarkers / Q000097:blood; D002315:Cardiopulmonary Bypass / Q000009:adverse effects* / Q000379:methods; D001026:Coronary Artery Bypass / Q000379:methods*; D016207:Cytokines / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D017063:Outcome Assessment, Health Care; D059035:Perioperative Period; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000379:methods*
chemical_list: D015415:Biomarkers; D016207:Cytokines
keywords: Coronary artery bypass grafting; cardiopulmonary bypass; cytokines; supportive ventilation