Inflammatory response after myocardial revascularization with or without cardiopulmonary bypass

Inflammatory response after myocardial revascularization with or without cardiopulmonary bypass

Author Brasil, Luiz A. Autor UNIFESP Google Scholar
Gomes, Walter J. Autor UNIFESP Google Scholar
Salomão, Reinaldo Autor UNIFESP Google Scholar
Buffolo, Enio Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Background. Tumor necrosis factor-alpha has been implicated in complications seen after cardiac operations with cardiopulmonary bypass. the release of tumor necrosis factor-alpha and its possible effects were studied in patients undergoing coronary artery bypass grafting with and without cardiopulmonary bypass.Methods. Twenty patients were studied, 10 with (group 1) and 10 without cardiopulmonary bypass (group 2). Serial blood samples were obtained before, during and up to 48 hours after operation. Circulating tumor necrosis factor-alpha levels, leukocyte counts, and erythrocyte sedimentation rates were measured. Hemodynamic variables (blood pressure and heart rate), temperature, orotracheal intubation time, postoperative bleeding, and inotropic drug requirements were compared.Results, Serum levels of tumor necrosis factor-alpha were detected in 6 patients (60%) in group 1 and none in group 2. the patients in group 1 had more hypotension than those in group 2 (7.4 +/- 1.0 mm Hg versus 8.5 +/- 0.7 mm Hg), required more inotropic drugs (8 patients versus 1 patient), and had a higher heart rate (114 +/- 8 beats per minute versus 98 +/- 10 beats per minute), a higher temperature (37.1 degrees +/- 0.5 degrees C versus 36.6 degrees +/- 0.3 degrees C), increased postoperative bleeding (820 +/- 120 mL versus 360 +/- 84 mL), a longer orotracheal intubation time (13.6 +/- 2.2 hours versus 9.3 +/- 1.4 hours), and a more pronounced leukocytosis.Conclusions. Cardiopulmonary bypass induces the whole-body inflammatory response through the release of tumor necrosis factor ct, resulting in adverse systemic effects, (Ann Thorac Surg 1998;66:56-9) (C) 1998 by the Society of Thoracic Surgeons.
Language English
Date 1998-07-01
Published in Annals of Thoracic Surgery. New York: Elsevier B.V., v. 66, n. 1, p. 56-59, 1998.
ISSN 0003-4975 (Sherpa/Romeo, impact factor)
Publisher Elsevier B.V.
Extent 56-59
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000074992000014

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