Key result
CPB during CABG is linked to cytokine and selectin dysregulation up to 48 hours postoperatively.
Why the study?
How does cardiopulmonary bypass during elective coronary artery bypass grafting affect plasma levels of interleukins and selectins?
Observational (n=20)
How does cardiopulmonary bypass during elective coronary artery bypass grafting affect plasma levels of interleukins and selectins?
Cardiopulmonary bypass during CABG induces significant alterations in cytokine and selectin levels up to 48 hours postoperatively, reflecting a systemic inflammatory stress response.
Answers are grounded in this paper and cite their sources.
Bypass-related cytokine and selectin dysregulation may signal heightened inflammatory risk after CABG; hypothesis-generating for targeted interventions in prospective trials.
BACKGROUND: Cardiovascular surgery with cardiopulmonary bypass (CPB) leads to activation of a variety of inflammatory pathways, including the release of cytokines and selectins. METHODS: In 20 patients undergoing elective coronary artery bypass grafting, plasma levels of interleukins IL-2, -6, -8, -10, -12 and of P-, E-, and L-selectins were measured at eight time points before, during, and after CPB using a standardized ELISA technique. RESULTS: IL-2 plasma levels decreased significantly after the start of CPB and remained low until the second postoperative day. IL-6 and IL-8 levels increased significantly after weaning off CPB, with mean peak values six hours postoperatively. Very low IL-10 plasma levels were detectable preoperatively. They remained low during CPB and peaked significantly after weaning off CPB until skin closure. The IL-12 levels decreased after weaning off CPB (p < 0.05) until 6 hours postoperatively. The plasma levels of P-selectin showed no alterations, but concentrations of E- and L-selectin decreased after the start of CPB (p < 0.05). There were no adverse postoperative events. CONCLUSIONS: The results of our study demonstrate a dysregulation of cytokine and selectin production during and up to 48 h after CPB, which may be a "normal" stress reaction to CPB.
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Sablotzki et al. (1999) conducted an observational in Elective coronary artery bypass grafting (n=20). Cardiopulmonary bypass vs. Preoperative baseline was evaluated on Plasma levels of interleukins (IL-2, -6, -8, -10, -12) and selectins (P-, E-, L-selectins) (p=<0.05). Cardiopulmonary bypass during elective CABG caused significant dysregulation of cytokines and selectins up to 48 hours postoperatively, including decreases in E- and L-selectins (p < 0.05).
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