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- Title
Oxygenation and release of inflammatory mediators after off-pump compared with after on-pump coronary artery bypass surgery.
- Authors
Rasmussen, B. S.; Laugesen, H.; Sollid, J.; Grønlund, J.; Rees, S. E.; Toft, E.; Gjedsted, J.; Dethlefsen, C.; Tønnesen, E.
- Abstract
Background: In a previous study, we showed that oxygenation was impaired for up to 5 day after conventional coronary artery bypass grafting (CABG). As cardiopulmonary bypass (CPB) may have a detrimental effect on pulmonary function, we hypothesized that coronary revascularization grafting without the use of CPB (OPCAB) would affect post-operative oxygenation and release of inflammatory mediators less compared with CABG. Methods: Low-risk patients scheduled for elective coronary revascularization were randomly assigned to one of two groups (CABG, n = 17 or OPCAB, n = 18). Two parameters of oxygenation, shunt (%) and ventilation-perfusions mismatch, described as ΔPO2 (kPa), were estimated for up to 5 days post-operatively. Systemic release of interleukin (IL)-6, -8 and -10, C-reactive protein (CRP) and neutrophils were measured in peripheral blood samples for up to 3 days post-operatively. The lungs participation in the cytokine response was evaluated from mixed venous blood samples taken within the first 16 h post-operatively. Results: OPCAB was followed by a higher shunt ( P = 0.047), with no difference ( P = 0.47) in the deterioration of ΔPO2 between the groups. OPCAB was followed by an attenuated systemic release of IL-8 ( P = 0.041) and IL-10 ( P = 0.006), while the release of IL-6 ( P = 0.94), CRP ( P = 0.121) and neutrophils ( P = 0.078) did not differ between the groups. Indications of an uptake of cytokines in the lungs were found after OPCAB. Conclusions: When comparing OPCAB with CABG, oxygenation was more affected and only part of the systemic inflammatory response was attenuated.
- Subjects
CORONARY artery bypass; NERVE grafting; CARDIOPULMONARY system; MYOCARDIAL revascularization; OXYGEN therapy; INFLAMMATORY mediators
- Publication
Acta Anaesthesiologica Scandinavica, 2007, Vol 51, Issue 9, p1202
- ISSN
0001-5172
- Publication type
Article
- DOI
10.1111/j.1399-6576.2007.01426.x