Document Detail

Ventilation during cardiopulmonary bypass: impact on cytokine response and cardiopulmonary function.
MedLine Citation:
PMID:  18154801     Owner:  NLM     Status:  MEDLINE    
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.
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    
Department of Cardiothoracic Surgery, The Chinese University of Hong Kong, Shatin, Hong Kong.
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MeSH Terms
Cardiopulmonary Bypass / adverse effects,  methods*
Coronary Angiography
Coronary Artery Bypass / methods,  mortality
Coronary Stenosis / blood,  mortality,  radiography,  surgery*
Cytokines / blood*
Follow-Up Studies
Heart Function Tests
Hemodynamics / physiology
Inflammation Mediators / blood
Intraoperative Care / methods*
Monitoring, Intraoperative / methods
Multivariate Analysis
Oxygen / therapeutic use
Prospective Studies
Reference Values
Respiration, Artificial / methods*
Respiratory Function Tests
Risk Assessment
Survival Rate
Treatment Outcome
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

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