Key result
Cardiopulmonary bypass linked to ~67% higher TNF-alpha levels vs off-pump coronary surgery.
Why the study?
Lung injury after cardiac surgery is believed to result from cardiopulmonary bypass and its pro-inflammatory effects, but this hypothesis requires testing.
Does coronary revascularisation with cardiopulmonary bypass increase inflammatory markers and worsen pulmonary function compared to surgery without cardiopulmonary bypass in coronary artery surgery patients?
Cohort
Does coronary revascularisation with cardiopulmonary bypass increase inflammatory markers and worsen pulmonary function compared to surgery without cardiopulmonary bypass in coronary artery surgery patients?
Absolute Event Rate: 3.68% vs 2.2%
p-value: p=0.043
Cardiopulmonary bypass during coronary surgery increases systemic inflammatory markers but does not appear to worsen pulmonary function or local pulmonary inflammation compared to off-pump surgery.
Bypass elevates systemic cytokines in observational data; leaves open whether this affects pulmonary outcomes or warrants off-pump preference.
Lung injury after cardiac surgery is believed to result from cardiopulmonary bypass and its pro-inflammatory effects. To test this hypothesis, we compared the oxygenation ratios, extravascular lung water indices and systemic and pulmonary tumour necrosis factor alpha (TNF-alpha) and interleukin (IL)-8 at predetermined intervals in coronary artery surgery patients with or without cardiopulmonary bypass. No differences in oxygenation ratios or extravascular lung water indices were found. Serum values of TNF-alpha and IL-8 increased in both groups but were higher in the cardiopulmonary bypass group (end of surgery: mean (SD) TNF-alpha 3.68 (2.5) vs 2.20 (1.2) pg.ml(-1) (p = 0.043 (CI 0.05-2.9)) and mean (SD) IL-8 19.45 (10.8) vs 6.31 (5.3) pg.ml(-1) (p = 0.001 (CI 6.9-19.3)). In broncho-alveolar lavage fluid, TNF-alpha and IL-8 increased in both groups with no differences between the groups.
No takes yet. Share an insight, caveat, or question.
Heijmans et al. (2007) conducted a cohort in Coronary artery surgery. Cardiopulmonary bypass vs. Without cardiopulmonary bypass was evaluated on Serum TNF-alpha at end of surgery (pg/ml) (95% CI 0.05-2.9, p=0.043). Cardiopulmonary bypass during coronary revascularisation was associated with higher serum TNF-alpha (3.68 vs 2.20 pg/ml; P=0.043) and IL-8 levels compared to surgery without bypass.
Synapse has enriched 2 closely related papers on similar clinical questions. Consider them for comparative context: