Journal of Artificial Organs

, Volume 10, Issue 2, pp 92–95

Minimal cardiopulmonary bypass attenuates neutrophil activation and cytokine release in coronary artery bypass grafting

  • Toshihiro Ohata
  • Masataka Mitsuno
  • Mitsuhiro Yamamura
  • Hiroe Tanaka
  • Yasuhiko Kobayashi
  • Masaaki Ryomoto
  • Yoshiteru Yoshioka
  • Yuji Miyamoto
ORIGINAL ARTICLE

Abstract

The minimal cardiopulmonary bypass (mini-CPB) circuit, a closed system with neither cardiotomy suction nor an open venous reservoir and thus no air–blood interface, reportedly reduces blood loss and inflammatory reactions associated with coronary bypass surgery. We evaluated the inflammatory reactions in patients in whom coronary bypass operations were performed with conventional CPB or mini-CPB (n = 15 each). Interleukin (IL)-6, IL-8, and neutrophil elastase levels; the neutrophil count; and the C-reactive protein value were measured before and immediately after surgery and on postoperative days 1 and 2. In addition, intraoperative blood loss and the transfusion volume were evaluated in these groups. Neutrophil elastase levels were lower in the mini-CPB group than in the conventional group on postoperative days 1 (127 ± 52 vs. 240 ± 100 µg/l, P = 0.013) and 2 (107 ± 17 vs. 170 ± 45 µ/l, P = 0.0001), as was the IL-8 level on postoperative day 1 (8.3 ± 6.4 vs. 19 ± 11 pg/ml, P = 0.016). The intraoperative blood loss and transfusion volumes were significantly lower in the mini-CPB group than in the conventional group (510 ± 244 vs. 1046 ± 966 ml, P = 0.012, and 691 ± 427 vs. 1416 ± 918 ml, P = 0.0033). Thus, mini-CPB appears to attenuate neutrophil activation and cytokine release after coronary bypass surgery and, in addition, has some beneficial effects on blood conservation.

Key words

Mini-CPB Inflammatory cytokine neutrophil elastase CABG 

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References

  1. 1.
    Frering, B, Philip, I, Dehoux, M, Rolland, C, Lanqlois, JM, Desmonts, JM 1994Circulatory cytokines in patients undergoing normothermic cardiopulmonary bypassJ Thorac Cardiovasc Surg108636641PubMedGoogle Scholar
  2. 2.
    Westaby, S 1987Organ dysfunction after cardiopulmonary bypass. A systemic inflammatory reaction initiated by the extracorporeal circuitIntensive Care Med138995PubMedCrossRefGoogle Scholar
  3. 3.
    Philipp, A, Foltan, M, Thrum, A 2002MECC – a minimal ECC system for coronary artery bypass proceduresJ Extracorp Technol34A215Google Scholar
  4. 4.
    Wiesenack, C, Liebold, A, Philipp, A, Ritzka, M, Koppenberg, J, Birnbaum, DE, Keyl, C 2004Four years' experience with a miniaturized extracorporeal circulation system and its influence on clinical outcomeArtif Organs2810821088PubMedCrossRefGoogle Scholar
  5. 5.
    Remadi, JP, Marticho, P, Butoi, I, Ratokoarivelo, Z, Trojette, F, Benamar, A, Beloucif, S, Foure, D, Poulain, H 2004Clinical experience with the mini-extracorporeal circulation system: An evolution or a revolution?Ann Thorac Surg7721722176PubMedCrossRefGoogle Scholar
  6. 6.
    Nathoe, HM, van Dijk, D, Jansen, EWL, Suyker, WJL, Diephuis, JC, Van Boven, WJ, de la Riviere, AB, Borst, C, Kalkman, CJ, Grobbee, DE, Buskens, E, de Jaeger, PPT 2003A comparison of on-pump and off-pump coronary bypass surgery in low-risk patientsN Engl J Med348394402PubMedCrossRefGoogle Scholar
  7. 7.
    Formes, Y, Gaillard, D, Ponzio, O, Chauffert, M, Gerhardt, MF, Deleuze, P, Bical, OM 2002Reduction of the inflammatory response following coronary artery bypass grafting with total minimal extracorporeal circulationEur J Cardiothorac Surg22527533CrossRefGoogle Scholar
  8. 8.
    Schoenberger, JPAM, Everts, PAM, Hoffmann, JJ 1995Systemic blood activation with open and closed venous reservoirsAnn Thorac Surg5915491555CrossRefGoogle Scholar
  9. 9.
    Kunkel, SL, Standiford, T, Kasahara, K, Strieter, RM 1991Interleukin-8 (IL-8): The major neutrophil chemotactic factor in the lungExp Lung Res171723PubMedGoogle Scholar

Copyright information

© The Japanese Society for Artificial Organs 2007

Authors and Affiliations

  • Toshihiro Ohata
    • 1
  • Masataka Mitsuno
    • 1
  • Mitsuhiro Yamamura
    • 1
  • Hiroe Tanaka
    • 1
  • Yasuhiko Kobayashi
    • 1
  • Masaaki Ryomoto
    • 1
  • Yoshiteru Yoshioka
    • 1
  • Yuji Miyamoto
    • 1
  1. 1.Department of Cardiovascular SurgeryHyogo College of MedicineJapan

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