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The Annals of Thoracic Surgery, Vol 53, 833-838, Copyright © 1992 by The Society of Thoracic Surgeons
J Butler, GL Chong, RJ Baigrie, R Pillai, S Westaby and GM Rocker
The systemic inflammatory response to cardiopulmonary bypass was assessed
in 20 patients who underwent elective coronary artery bypass grafting with
flat-sheet membrane oxygenation (group I; n = 10; age, 59 +/- 5 years) or
bubble oxygenation (group II; n = 10; age, 62 +/- 8 years). The duration of
cardiopulmonary bypass was 46 +/- 12 minutes in group I and 47 +/- 15
minutes in group II. Plasma interleukin-6, plasma interleukin-1 beta,
transpulmonary leukocyte counts, pulmonary hemodynamic variables, and
respiratory index were determined in all patients perioperatively. The
plasma interleukin-6 response (median [range]) was similar in both groups
at the end of the operation, peaked 4 hours postoperatively (99 [30 to 320]
pg/mL in group I; 123 [21 to 300] pg/mL in group II; p greater than 0.05),
and remained elevated 48 hours postoperatively (76 [9 to 140] pg/mL in
group I; 65 [25 to 159] pg/mL in group II; p greater than 0.05). No
significant interleukin-1 beta response was demonstrated. Pulmonary
neutrophil and lymphocyte sequestration was observed on commencement of
cardiopulmonary bypass in group II but did not occur in either group on
discontinuation of cardiopulmonary bypass. Pulmonary vascular resistance at
the end of the operation (82 [48 to 320] dynes.s.cm-5 in group I; 119 [54
to 385] dynes.s.cm-5 in group II; p greater than 0.05) was similar to
preoperative values (151 [30 to 327] dynes.s.cm-5 in group I; 185 [62 to
291] dynes.s.cm-5 in group II; p greater than 0.05). The respiratory index
at the end of the operation was similarly and significantly increased in
both groups (1.26 [0.92 to 4.17] in group I; 1.44 [0.73 to 3.30] in group
II).(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
Cytokine responses to cardiopulmonary bypass with membrane and bubble oxygenation
Department of Cardiothoracic Surgery, Oxford Heart Centre, England.
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