Advertisement

Cytokine release regarding different perfusion systems and its effect on S100B protein levels

  • Jörg Babin-Ebell
  • M. Misoph
  • O. Elert
Conference paper

Abstract

During cardiopulmonary bypass (CPB), blood is exposed to foreign surfaces and abnormal sheer forces. These abnormal conditions lead to an activation of coagulation (9), fibrinolysis (9), the complement pathway (2) and of the cellular and humoral immune system (15), finally resulting in a general inflammatory reaction. Clinically, this so-called “post pump response” is linked to myocardial dysfunction, respiratory distress, renal failure, and neurological deficits. All these clinical aspects are mostly consequences of endothelial injury and increased vascular permeability — at least partly caused by the release of cytokines, which are known to mediate vascular injury and organ dysfunction (4, 14).

Keywords

Cardiopulmonary Bypass Centrifugal Pump Perfusion System Protamine Administration S100B Concentration 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Aberg T (1995) Signs of brain cell injury during open heart operations: past and present. Ann Thorac Surg 59:1312–1315PubMedCrossRefGoogle Scholar
  2. 2.
    Bonser RS, Dave J, Gademsetty M, Carter P, Davies E, Taylor P, Gaya H, Lennox SC, Vergani D (1990) Complement activation before, during and after cardiopulmonary bypass. Eur J Cardio-thorac Surg 4:291–296CrossRefGoogle Scholar
  3. 3.
    Breuer AC, Furlan AJ, Hanson MR et al (1983) Central nervous system complications of coronary artery bypass graft surgery: prospective analysis of 421 patients. Stroke 14:682–687PubMedCrossRefGoogle Scholar
  4. 4.
    Casey LC (1993) Role of cytokines in the pathogenesis of cardiopulmonary-induced multisystem organ failure. Ann Thorac Surg 56:92–96CrossRefGoogle Scholar
  5. 5.
    Cavaillon JM, Fitting C, Haeffner-Cavaillon N (1990) Recombinated C5a enhances inter-leukin 1 and tumor necrosis factor release by lipopolysaccharid-stimulated monocytes and macrophages. Eur J Immunol 20:253–257PubMedCrossRefGoogle Scholar
  6. 6.
    Cruickshank AM, Fraser WD, Burns HJ, Van Damme J, Shenkin A (1990) Response of serum interleukin-6 in patients undergoing elective surgery of varying severity. Clin Sci Colch 79:161–165PubMedGoogle Scholar
  7. 7.
    Finn A, Naik S, Klein N, Levinsky R, Strobel S, Elliott M (1993) Interleukin-8 release and neutrophil degranulation after pediatric cardiopulmonary bypass. J Thorac Cardiovasc Surg 105:234–241PubMedGoogle Scholar
  8. 8.
    Gorman RC, Ziats NP, Rao AK, Gikakis N, Sun L, Kahn MMH, Stenach N, Sapatnekar S, Chouhan V, Gorman JH, Niewiarowski S, Colman RW, Anderson JM, Edmunds LH (1996) Surface-bound heparin fails to reduce thrombin formation during clinical cardiopulmonary bypass. J Thorac Cardiovasc Surg 111:1–12PubMedCrossRefGoogle Scholar
  9. 9.
    Grossmann R, Babin-Ebell J, Misoph M, Schwender S, Neukam K, Hickethier Th, Elert O, Keller F (1996) Changes in coagulation and fibrinolytic parameters caused by extracorporeal circulation. Heart Vessels 11:310–317PubMedCrossRefGoogle Scholar
  10. 10.
    Hennein HA, Ebba H, Rodriguez JL, Merrick SH, Keith FM, Bronstein MH, Leung JM, Mangano DT, Greenfield LJ, Rankin JS (1994) Relationship of the proinflammatory cytokines to myocardial ischemia and dysfunction after uncomplicated coronary revascularization. J Thorac Cardiovasc Surg 108:626–635PubMedGoogle Scholar
  11. 11.
    Jakob H, Kutschera Y, Palzer B, Prellwitz W, Oelert H (1990) In-Vitro Assessment of Centrifugal Pumps for Ventricular Assist. Artif Organs 14(4):278–283PubMedCrossRefGoogle Scholar
  12. 12.
    Jansen PGM, te Velthuis H, Huybregts RAJM, Paulus R, Bulder ER, van der Spoel HI, Bezemer PD, Slaats EH, Eijsman L, Wildevuur CHR (1995) Reduced complement activation and improved postoperative performance after cardiopulmonary bypass with heparin-coated circuits. J Thorac Cardiovasc Surg 110:829–834PubMedCrossRefGoogle Scholar
  13. 13.
    Johnsson P (1996) Markers of cerebral ischemia after cardiac surgery. J Cardiothorac Vasc Anesth 10:120–126PubMedCrossRefGoogle Scholar
  14. 14.
    Kawamura T, Wakusawa R, Kazutoshi O, Inada S (1993) Elevation of cytokines during open heart surgery with cardiopulmonary bypass: participation of interleukin 8 and 6 in reperfusion injury. Can J Anaesth 40(11): 1016–1021PubMedCrossRefGoogle Scholar
  15. 15.
    Misoph M, Babin-Ebell J (1997) Interindividual variations in cytokine levels following cardiopulmonary bypass. Heart Vessels 12:119–127PubMedCrossRefGoogle Scholar
  16. 16.
    Murkin JM (1995) The role of CPB management in neurobehavioural outcomes after cardiac surgery. Ann Thorac Surg 59:1308–1311PubMedCrossRefGoogle Scholar
  17. 17.
    Prodzinsky R, Witthaut R, Stabenow I, Lehrmann D, Redling F, Fraunberger P, Walli AK, Seidel D, Zerkowski HR, Teichmann W, Werdan K (1997) The cardiopulmonary bypass supported high-risk PTCA (CPB-PTCA): a useful model for the study of CPB-dependent systemic inflammatory response syndrom (SIRS)? Crit Care l(Suppl 1):S41Google Scholar
  18. 18.
    Pugsley W, Klinger L, Paschalis C, Treasure T, Harrison M, Newman S (1994) The impact of microemboli during cardiopulmonary bypass on neuropsychological functioning. Stroke 25:1393–1399PubMedCrossRefGoogle Scholar
  19. 19.
    Shenkin A, Fraser WD, Series J, Winstanley FP, McCartney AC, Burns HJ, Van Damme J (1989) The serum interleukin 6 response to elective surgery. Lymphokine Res 8:123–127PubMedGoogle Scholar
  20. 20.
    Waterloo K, Ingebritsen T, Romner B (1997) Neuropsychological function in patients with increased serum levels of protein S-100 after minor head injury. Acta Neurochir Wien 139:26–32PubMedCrossRefGoogle Scholar
  21. 21.
    Westaby S, Johnsson P, Parry AJ et al (1996) Serum S100 protein: a potential marker for cerebral events during cardiopulmonary bypass. Ann Thorac Surg 61:88–92PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2000

Authors and Affiliations

  • Jörg Babin-Ebell
    • 1
  • M. Misoph
    • 1
  • O. Elert
    • 1
  1. 1.Klinik und Poliklinik für Herz- und ThoraxchirurgieUniversität WürzburgWürzburgGermany

Personalised recommendations