Circulating cytokines and granulocyte-derived enzymes during complex heart surgery: A clinical study with special reference to heparin-coating of cardiopulmonary bypass circuits

Circulating cytokines and granulocyte-derived enzymes during complex heart surgery : A clinical study with special reference to heparin-coating of cardiopulmonary bypass circuits

Borowiec, Jan W. (author): Uppsala universitet,Institutionen för kirurgiska vetenskaper,Thoracic Surgery

Hagman, Leif (author)

Tötterman, Thomas H. (author): Uppsala universitet,Institutionen för onkologi, radiologi och klinisk immunologi,KITM

Pekna, M. (author): Uppsala universitet,Institutionen för onkologi, radiologi och klinisk immunologi,KITM

Venge, Per (author): Uppsala universitet,Institutionen för medicinska vetenskaper

Thelin, Stefan (author): Uppsala universitet,Institutionen för kirurgiska vetenskaper,Thoracic Surgery

(creator_code:org_t)

1995
1995
English.
In: Scandinavian journal of thoracic and cardiovascular surgery. - 0036-5580. ; 29:4, s. 167-174

Abstract Subject headings

Blood contact with artificial surfaces during cardiopulmonary bypass (CPB) triggers a systemic inflammatory response in which complement, granulocytes and cytokines play a major role. Heparin-coated CPB circuits were recently shown to reduce complement and granulocyte activation in such circumstances. The present study comprised 20 complex heart operations, 10 with heparin-coated circuits (group HC) and 10 controls (group C), with evaluation of changes in terminal complement complex, the granulocyte enzymes myeloperoxidase and lactoferrin, and the cytokines interleukin-6 (IL-6) and interleukin-8 (IL-8). Standard heparin dose and uncoated cardiotomy reservoir were used in all cases. In both groups the levels of enzymes and terminal complement complex rose significantly, beginning at conclusion of CPB, above base values, without significant intergroup differences. IL-6 and IL-8 also increased significantly, but tended to be lower in the HC group, starting at CPB end and continuing until 20 hours postoperatively: for IL-6 the difference was significant at CPB end (83 +/- 18 vs 197 +/- 39 micrograms/l, p = 0.21). Significantly increased inflammatory response was thus found during complex heart operations even with use of heparin-coated CPB sets. The heparin-coating of circuits seems to diminish cytokine production.

By the author/editor: Borowiec, Jan W.; Hagman, Leif; Tötterman, Thoma ...; Pekna, M.; Venge, Per; Thelin, Stefan

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