Cytokine response to cardiopulmonary bypass and cardiac performance in coronary artery bypass graft surgery

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