title: Comparison of Two Miniaturized Cardiopulmonary Bypass Systems Regarding Inflammatory Response.
abstract: Cardiopulmonary bypass (CPB) is a known mediator of systemic inflammatory response. Extracorporeal circulations are undergoing continuous modifications and optimizations to achieve better results. Hence we aim to compare the inflammatory response associated with two recent miniature extracorporeal circulation systems during normothermic CPB. We measured plasma levels of cytokines including interleukin (IL)-1β, IL-6, IL-10, tumor necrosis factor-α, migration inhibitory factor (MIF), receptor for advanced glycation endproduct, and cluster of differentiation 40 ligand in 60 consecutive patients during the first 24 h after CPB. The patients were prospectively randomized to one of three trial groups: patients in group A were operated with the minimal extracorporeal circulation circuit (MECC, Maquet, Rastatt, Germany), group B operated with the extracorporeal circulation circuit optimized (ECC.O, Sorin, Italy), and group C operated with a conventional extracorporeal circuit (CECC, Maquet). Arterial blood samples were collected at intervals before, 30 min after initiation, and after termination of CPB. Further samples were collected 6 and 24 h after CPB. IL-10 levels were significantly raised in the CECC group as compared with either of the mini ECC-circuits with a peak concentration at 6 h postoperatively. Human MIF concentrations were significantly higher in the CECC group starting 30 min after CPB and peaking at the end of CPB. The overall reduction in cytokine concentrations in the mini-ECC groups correlated with a lower need for blood transfusion in MECC and a shorter mechanical ventilation time for ECC.O. Normothermic CPB using minimally invasive extracorporeal circulation circuits can reduce the inflammatory response as measured by cytokine levels, which may be beneficial for perioperative preservation of pulmonary function and hemostasis in low risk patients.
authors.affiliation: Department of Cardiac Surgery, Heart and Marfan Center, University of Heidelberg, Heidelberg, Germany.
authors.forename: Mina
authors.initials: M
authors.lastname: Farag
authors.affiliation: Department of Cardiothoracic Surgery, Royal Brompton and Harefield NHS Foundation Trust, Harefield, Middlesex, London, UK.
authors.forename: Nikhil Prakash
authors.initials: NP
authors.lastname: Patil
authors.affiliation: Department of Cardiothoracic Surgery, Heart Center, University of Cologne, Cologne.
authors.forename: Anton
authors.initials: A
authors.lastname: Sabashnikov
authors.affiliation: Department of Cardiac Surgery, Heart and Marfan Center, University of Heidelberg, Heidelberg, Germany.
authors.forename: Rawa
authors.initials: R
authors.lastname: Arif
authors.affiliation: Department of Cardiac Surgery, Heart and Marfan Center, University of Heidelberg, Heidelberg, Germany.
authors.forename: Gábor
authors.initials: G
authors.lastname: Szabó
authors.affiliation: Department of Cardiac Surgery, Heart and Marfan Center, University of Heidelberg, Heidelberg, Germany.|INCCI HAERZ ZENTER, Luxembourg.
authors.forename: Klaus
authors.initials: K
authors.lastname: Kallenbach
authors.affiliation: Department of Cardiac Surgery, Heart and Marfan Center, University of Heidelberg, Heidelberg, Germany.
authors.forename: Arjang
authors.initials: A
authors.lastname: Ruhparwar
authors.affiliation: Department of Cardiac Surgery, Heart and Marfan Center, University of Heidelberg, Heidelberg, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Karck
authors.affiliation: Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany.
authors.forename: Thorsten
authors.initials: T
authors.lastname: Brenner
authors.affiliation: Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Hofer
authors.affiliation: Department of Cardiac Surgery, Heart and Marfan Center, University of Heidelberg, Heidelberg, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Weymann
mesh_terms: D000368:Aged; D002315:Cardiopulmonary Bypass / Q000009:adverse effects* / Q000295:instrumentation*; D016207:Cytokines / Q000097:blood* / Q000276:immunology; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000209:etiology* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D008904:Miniaturization / Q000295:instrumentation*; D011446:Prospective Studies; D013696:Temperature; D016896:Treatment Outcome
chemical_list: D016207:Cytokines
keywords: Coronary artery bypass grafting; Cytokine release; Inflammatory response; Miniaturized extracorporeal circulation