Effects of cardiopulmonary bypass on plasma levels of procalcitonin and cytokines / 中华麻醉学杂志

ABSTRACT

ve To investigate the changes in perioperative levels of circulating procalcitonin (PCT), TNF-?, IL-6, IL-8 and IL-10 in patients undergoing valve replacement with cardiopulmonary bypass (CPB) .Methods Sixteen patients (7 male, 9 female) aged (38.5?5.1) years and weighing (42.9?10.2) kg, undergoing valve replacement under CPB were chosen in this study as CPB group and seven male patients aged (32.6?5.1) years and weighing (58.3?4.4) kg undergoing pericardectomy were enrolled in this study as non-CPB group. Patients with infection or immunodeficiency and those who had received corticosteroid and drugs which may affect immune function were excluded. Premedication consisted of intramuscular midazolam 0.1 mg/kg and morphine 0.1 mg/kg. Anesthesia was induced with midazolam 0.15mg/kg, fentanyl 8?g/kg and vecuronium 0.1mg/kg and maintained with 0.8%-1.2% isoflurane inhalation and intermittent iv boluses of fentanyl and vecuronium. Blood samples were taken from CVP line before induction of anesthesia, 5 min after tracheal intubation, before CPB, immediately after discontinuation of CPB, and on 1st, 3rd, 5th, 7th postoperative day for determination of plasma PCT, TNF-?, IL-6, IL-8, and IL-10 levels. Results In CPB group plasma TNF-?, IL-6, IL-8 and IL-10 levels increased significantly immediately after CPB and returned to the baseline levels on the 3rd postoperative day, while plasma PCT concentration increased significantly after operation and reached its peak level of (10.62?3. 51) ng/ml on the 1st postoperative day. In non-CPB group there was a similar trend of changes in PCT , IL-6, IL-8 and IL-10 but to a much lesser extent.Conclusions CPB leads to a pro- and anti-inflammatory response, as well as procalcitonin release. PCT may play an important role in the systemic inflammation induced by CPB.