| Ventilation during cardiopulmonary bypass: impact on cytokine response and cardiopulmonary function. | |
| | |
MedLine Citation:
|
PMID: 18154801 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: A complex inflammatory response associated with the use of cardiopulmonary bypass may ultimately lead to organ dysfunction. We investigate the effect of continuing ventilation during cardiopulmonary bypass on inflammatory reactions and cardiopulmonary function. METHODS: Fifty patients undergoing cardiopulmonary bypass were prospectively randomized to continuous ventilation and nonventilation groups. Plasma interleukin-8, interleukin-10, matrix metalloproteinase-9, tissue inhibitor metalloproteinase-1, and thromboxane B2 levels were measured preoperatively, at 1, 4, and 6 hours after aortic declamping. Levels of these mediators were also determined in bronchoalveolar lavage preoperatively and four hours after declamping. Seven parameters of cardiopulmonary function, including dynamic compliance and systemic vascular resistance, were recorded during the same time points. RESULTS: Plasma interleukin-10 levels were higher at 6 hours and tissue inhibitor metalloproteinase-1 levels were higher at 1 hour after aortic declamping in the continuous ventilation compared with the nonventilation group (p = 0.04 and 0.002, respectively), while bronchoalveolar lavage levels of tissue inhibitor metalloproteinase-1 were also higher in the continuous ventilation group 4 hours after declamping (p = 0.02). Plasma interleukin-8 levels were higher at 4 hours after declamping in the nonventilation group (p = 0.04). Postoperative dynamic compliance was better preserved in continuous ventilation patients than nonventilation patients at 6 hours after declamping (p = 0.0008). CONCLUSIONS: Continued ventilation during cardiopulmonary bypass results in lesser inflammatory and proteolytic responses, and may better preserve pulmonary function than cardiopulmonary bypass without ventilation. |
| | |
Authors:
|
Calvin S H Ng; Ahmed A Arifi; Song Wan; Anthony M H Ho; Innes Y P Wan; Eric M C Wong; Anthony P C Yim |
Publication Detail:
|
Type: Journal Article; Randomized Controlled Trial |
Journal Detail:
|
Title: The Annals of thoracic surgery Volume: 85 ISSN: 1552-6259 ISO Abbreviation: Ann. Thorac. Surg. Publication Date: 2008 Jan |
Date Detail:
|
Created Date: 2007-12-24 Completed Date: 2008-01-25 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 15030100R Medline TA: Ann Thorac Surg Country: Netherlands |
Other Details:
|
Languages: eng Pagination: 154-62 Citation Subset: AIM; IM |
Affiliation:
|
Department of Cardiothoracic Surgery, The Chinese University of Hong Kong, Shatin, Hong Kong. calvinng@surgery.cuhk.edu.hk |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Cardiopulmonary Bypass
/
adverse effects,
methods* Coronary Angiography Coronary Artery Bypass / methods, mortality Coronary Stenosis / blood, mortality, radiography, surgery* Cytokines / blood* Female Follow-Up Studies Heart Function Tests Hemodynamics / physiology Humans Inflammation Mediators / blood Intraoperative Care / methods* Male Monitoring, Intraoperative / methods Multivariate Analysis Oxygen / therapeutic use Probability Prospective Studies Reference Values Respiration, Artificial / methods* Respiratory Function Tests Risk Assessment Survival Rate Treatment Outcome |
| Chemical | |
Reg. No./Substance:
|
0/Cytokines; 0/Inflammation Mediators; 7782-44-7/Oxygen |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Cardiac surgery in patients on dialysis: decreased 30-day mortality, unchanged overall survival.
Next Document: Tricuspid regurgitation in patients undergoing pericardiectomy for constrictive pericarditis.