Measurement of Cytokine Levels by Coronary Sinus Blood Sampling During Cardiac Surgery With Cardiopulmonary Bypass

Interleukin-6, interleukin-8, and polymorphonuclear leukocyte elastase levels in coronary sinus blood were measured and compared with those in arterial blood drawn from the radial artery before and immediately after cardiopulmonary bypass (CPB) during coronary artery bypass grafting in 20 patients. We introduced coronary sinus blood sampling as a useful method for evaluation of myocardial metabolism, myocardial protection, and reperfusion injury during CPB, especially by measurement of cytokines. Because interleukin-6, interleukin-8, and polymorphonuclear leukocyte elastase are inflammatory mediators, we speculated that they might show higher levels in coronary sinus blood than in systemic arterial blood. The results obtained from the 20 patients showed that levels of interleukin-6, interleukin-8, and polymorphonuclear leukocyte elastase increased immediately after CPB (p < .01), but there was no significant difference in these levels between coronary sinus and systemic arterial blood. We conclude that the myocardium is not a predominant source of their release during CPB. Our results also showed that the measurement of these cytokines in systemic arterial blood reflected their levels in the whole body, including the myocardium, even during cardiac operation with CPB.