ABSTRACT
In this work, 20 patients undergoing coronary artery bypass graft surgery were studied. Anesthesia and cardiopulmonary bypass were standardized. Monitoring consisted of an electrocardiogram, a pulmonary artery catheter and an intraarterial line. Ventricular performance was assessed with standard parameters including central venous pressure [CVP], pulmonary arterial pressure [PAP], pulmonary capillary wedge pressure [PCWP], cardiac output [CO], heart rate, systemic blood pressure and left ventricular ejection fraction [estimated by transthoracic echocardiography]. All parameters were measured pre bypass, three hours after termination of cardiopulmonary bypass and one day after the onset of bypass. Levels of TNF-alpha, IL-1 beta, IL-6 and IL-8 were determined from blood samples collected from each patient before cardiopulmonary bypass and three hours and one day after the onset of bypass. TNF-alpha, IL-6 and IL-8 were increased by cardiopulmonary bypass. TNF-alpha and IL-8 were associated with tachycardia, hypotension, high PCWP, low CO and ejection fraction <50%, TNF-alpha was also associated with high CVP and high PAP. IL-6 was not associated with impaired hemodynamics. These results suggested an association between TNF-alpha and IL-8 and poor cardiac performance after coronary artery bypass graft with cardiopulmonary bypass