Cytokine responses to cardiopulmonary bypass with membrane and bubble oxygenation

The systemic inflammatory response to cardiopulmonary bypass was assessed in 20 patients who underwent elective coronary artery bypass grafting with flat-sheet membrane oxygenation (group I; n = 10; age, 59 +/- 5 years) or bubble oxygenation (group II; n = 10; age, 62 +/- 8 years). The duration of cardiopulmonary bypass was 46 +/- 12 minutes in group I and 47 +/- 15 minutes in group II. Plasma interleukin-6, plasma interleukin-1 beta, transpulmonary leukocyte counts, pulmonary hemodynamic variables, and respiratory index were determined in all patients perioperatively. The plasma interleukin-6 response (median range) was similar in both groups at the end of the operation, peaked 4 hours postoperatively (99 30 to 320 pg/mL in group I; 123 21 to 300 pg/mL in group II; p greater than 0.05), and remained elevated 48 hours postoperatively (76 9 to 140 pg/mL in group I; 65 25 to 159 pg/mL in group II; p greater than 0.05). No significant interleukin-1 beta response was demonstrated. Pulmonary neutrophil and lymphocyte sequestration was observed on commencement of cardiopulmonary bypass in group II but did not occur in either group on discontinuation of cardiopulmonary bypass. Pulmonary vascular resistance at the end of the operation (82 48 to 320 dynes.s.cm-5 in group I; 119 54 to 385 dynes.s.cm-5 in group II; p greater than 0.05) was similar to preoperative values (151 30 to 327 dynes.s.cm-5 in group I; 185 62 to 291 dynes.s.cm-5 in group II; p greater than 0.05). The respiratory index at the end of the operation was similarly and significantly increased in both groups (1.26 0.92 to 4.17 in group I; 1.44 0.73 to 3.30 in group II).(ABSTRACT TRUNCATED AT 250 WORDS)