Details

Autor(en) / Beteiligte

• Ashraf, Saeed
• Butler, John
• Tian, Yi
• Cowan, Dahlia
• Lintin, Simon
• Saunders, Nigel R
• Watterson, Kevin G
• Martin, Paul G

Titel

Inflammatory Mediators in Adults Undergoing Cardiopulmonary Bypass: Comparison of Centrifugal and Roller Pumps

Ist Teil von

• The Annals of thoracic surgery, 1998-02, Vol.65 (2), p.480-484

Ort / Verlag

New York, NY: Elsevier Inc

Erscheinungsjahr

1998

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Background. The nonocclusive centrifugal pump is used for cardiopulmonary bypass (CPB) and mechanical cardiac assistance. This study examined its impact on proinflammatory cytokine release. Methods. Forty-one patients undergoing elective coronary artery bypass grafting were randomized prospectively to either a standard roller pump group (n = 21) or a centrifugal vortex pump group (n = 20) for CPB. The two groups were well matched in age, sex, severity of disease, and duration of CPB and aortic cross-clamping. Plasma levels of the cytokines tumor necrosis factor-α, interleukin-1β, interleukin-6, and interleukin-8, as well as terminal complement, neutrophil counts, and leukocyte elastase, were analyzed before, during, and after CPB. Results. In both groups, traces of tumor necrosis factor-α were observed infrequently and interleukin-1β was not detected. Plasma levels of interleukin-6 and interleukin-8 increased during and after CPB, reaching a peak at 2 hours after protamine administration in both groups before returning toward baseline at 24 hours. The release of interleukin-6 was significantly greater in the centrifugal group ( p < 0.05), whereas the interleukin-8 concentration did not differ between the groups throughout the study period. Levels of terminal complement increased in both groups perioperatively, reaching a peak 30 minutes after protamine administration, whereas neutrophil counts and elastase peaked 2 hours after protamine administration. Plasma terminal complement, neutrophil counts, and elastase release were significantly higher in the centrifugal group ( p < 0.05). Peak terminal complement correlated ( r = 0.64, p < 0.01) with peak elastase in the centrifugal group only. Conclusions. This study confirms the proinflammatory nature of CPB in adults and demonstrates that use of the centrifugal pump induces a greater systemic inflammatory response than use of the standard roller pump.