Oxygenation and release of inflammatory mediators after off-pump compared with after on-pump coronary artery bypass surgery

B.S. Rasmussen, Helle Laugesen, J. Sollid, J. Grønlund, Stephen Edward Rees, Egon Toft, J. Gjedsted, Claus Dethlefsen, E. Tønnesen

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

32 Citationer (Scopus)

Abstrakt

Background: In a previous study, we showed that oxygenation was impaired for up to 5 day after conventional coronary artery bypass grafting (CABG). As cardiopulmonary bypass (CPB) may have a detrimental effect on pulmonary function, we hypothesized that coronary revascularization grafting without the use of CPB (OPCAB) would affect post-operative oxygenation and release of inflammatory mediators less compared with CABG.

Methods: Low-risk patients scheduled for elective coronary revascularization were randomly assigned to one of two groups (CABG, n = 17 or OPCAB, n = 18). Two parameters of oxygenation, shunt (%) and ventilation-perfusions mismatch, described as ΔPO2 (kPa), were estimated for up to 5 days post-operatively. Systemic release of interleukin (IL)-6, -8 and -10, C-reactive protein (CRP) and neutrophils were measured in peripheral blood samples for up to 3 days post-operatively. The lungs participation in the cytokine response was evaluated from mixed venous blood samples taken within the first 16 h post-operatively.

Results: OPCAB was followed by a higher shunt (P = 0.047), with no difference (P = 0.47) in the deterioration of ΔPO2 between the groups. OPCAB was followed by an attenuated systemic release of IL-8 (P = 0.041) and IL-10 (P = 0.006), while the release of IL-6 (P = 0.94), CRP (P = 0.121) and neutrophils (P = 0.078) did not differ between the groups. Indications of an uptake of cytokines in the lungs were found after OPCAB.

Conclusions: When comparing OPCAB with CABG, oxygenation was more affected and only part of the systemic inflammatory response was attenuated.


Udgivelsesdato: OCT
OriginalsprogEngelsk
TidsskriftActa Anaesthesiologica Scandinavica
Vol/bind51
Udgave nummer9
Sider (fra-til)1202-1210
Antal sider9
ISSN0001-5172
DOI
StatusUdgivet - okt. 2007

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