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Normothermic Ex Situ Heart Perfusion in Working Mode: Assessment of Cardiac Function and Metabolism
09:10

Normothermic Ex Situ Heart Perfusion in Working Mode: Assessment of Cardiac Function and Metabolism

Published on: January 12, 2019

Modulating IL-6 and IL-10 levels by pharmacologic strategies and the impact of different extracorporeal circulation

F Harig1, B Hohenstein, J von der Emde

  • 1Center for Cardiac Surgery, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany.

Shock (Augusta, Ga.)
|January 5, 2002
PubMed

Insights

Steroids and heparin-coated circuits can modulate cytokine release during coronary artery bypass grafting (CABG). This study found that these interventions affect interleukin-6 (IL-6) and interleukin-10 (IL-10) levels, influencing the acute phase response.

Area of Science:

  • Cardiovascular Surgery
  • Immunology
  • Biochemistry

Background:

  • Postoperative morbidity following coronary artery bypass grafting (CABG) is influenced by inflammatory cytokines, including interleukin-6 (IL-6) and interleukin-10 (IL-10).
  • The acute phase response, triggered by these cytokines, can be modulated by various interventions during cardiopulmonary bypass (CPB).

Purpose of the Study:

  • To investigate the impact of steroid treatment (prednisolone), aprotinin, and heparin-coated circuits on systemic IL-6 and IL-10 release in CABG patients.
  • To analyze correlations between hemodynamic and biochemical parameters of CPB and measured cytokine levels.

Main Methods:

  • Prospective randomized study involving four groups of 40 patients undergoing CABG.
  • Group 1: Prednisolone; Group 2: Aprotinin; Group 3: Heparin-coated circuits; Group 4: Standard medication (control).
  • Cytokine levels (IL-6, IL-10) measured by ELISA; 20 hemodynamic and biochemical parameters analyzed.

Main Results:

  • Steroid treatment (Group 1) suppressed IL-6 (P<0.01) and upregulated IL-10 (P<0.01). Aprotinin (Group 2) showed similar effects.
  • Heparin-coated circuits (Group 3) suppressed IL-6 (P<0.05) and upregulated IL-10 (P<0.05).
  • Cytokine levels correlated exponentially with cardiac ischemia time, CPB duration, and negative base excess. Inverse relationships observed with SvO2 and MAP. Hypothermia reduced cytokine release, but prolonged hypothermia increased it.

Conclusions:

  • Pharmacological interventions (steroids, aprotinin) and modified perfusion regimens (heparin-coated circuits) can modulate systemic cytokine release during extracorporeal circulation (ECC).
  • These modulations may impact the acute phase response and subsequent postoperative morbidity in CABG patients.

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