The Role of Cytokines in the Pathogenesis of Organ Dysfunction During Open Heart Surgery

Highlights The article presents an analysis of works on systemic inflammatory response that occurs during cardiac surgery, as well as research data on promising pharmacological strategies and the results of experimental research aimed at reducing the inflammatory response. Moreover, the authors proposed technological solutions to reduce the release of cytokines during cardiopulmonary bypass. Abstract The increase in the number of surgical revascularization procedures is one of the many reasons for the study of predictors of poor long-term prognosis after coronary artery bypass grafting (CABG). Recently, the issues associated with systemic inflammatory response have become even more urgent since cytokines play an important role in critical conditions. The aim of this work was to analyze the available data on the role of cytokines in CABG. The article presents research data reflecting the importance of studying the changes in tumor necrosis α (TNFα) and interleukins (IL), and the analysis of data on the impact of the types of circulatory assist devices on changes in cytokine concentration. The authors evaluated the possible pharmacological strategies to reduce the systemic inflammatory response, and obtained data on the possibility of using methylprednisolone, colchicine, and pentoxifylline in cardiac surgery patients to reduce the levels of pro-inflammatory cytokines. Experimental studies on the use of adenosine and monoclonal anti-TNFα antibodies seem promising due to a decrease in myocardial and lung injury. Numerous studies in this area confirm the need to develop methods for effective reduction of the inflammatory response after surgical myocardial revascularization.