Effects of corticosteroids on inflammatory response following cardiopulmonary bypass

To investigate the effects of corticosteroids on the reduction of inflammatory response after cardiopulmonary bypass.

Twenty patients undergoing elective coronary revascularization were randomized into two groups, which both underwent coronary artery bypass surgery with the aid of normothermic cardiopulmonary bypass. One group received a single dose of methylprednisolone prior to normothermic cardiopulmonary bypass, whereas no steroid treatment was given to other group of patients. The two groups were comparable with respect to preoperative demographic data. Serum samples from all patients were drawn preoperatively and 3, 6, and 24 hours after the surgical procedure. The serum concentrations of tumor necrosis factor alpha (TNF-alpha), interleukin-1beta (IL-1beta), interleukin-6 (IL-6), interleukin-8 (IL-8), as well as the white blood cell count were measured. Serum C-reactive protein concentrations (CRP) were determined preoperatively and 72 hours postoperatively. Standard hemodynamic measurements for both groups were collected and analyzed.

We did not find any increase in the postoperative concentrations of TNF-alpha and IL-1beta in either group. The concentrations of IL-6 and IL-8 increased significantly in both groups, from immeasurable concentrations preoperatively to as high as 496 pg/mL for IL-6 and 128 pg/mL for IL-8 three hours after surgery. However, the observed increase was significantly smaller in the group of patients receiving methylprednisolone.

It seems that the administration of corticosteroids prior to the initiation of cardiopulmonary bypass may alleviate the intensity of the inflammatory response, as evidenced by reduced increase in inflammatory mediators.