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[Evaluation of cytokine levels and pulmonary function in patients undergoing coronary artery bypass graft]
Luciano Brandão Machado1, Elnara Marcia Negri, Wanderley Wesley Bonafé
1Physician of the Serviço de Anestesiologia UNIANEST, Bauru-SP.
Insights
Systemic inflammatory response syndrome increased cytokine levels after cardiopulmonary bypass (CB) during coronary artery bypass grafts surgery. Elevated cytokines correlated with reduced lung compliance and longer CB duration, impacting patient recovery.
Area of Science:
- Cardiovascular Surgery
- Immunology
- Pulmonary Medicine
Context:
- Systemic inflammatory response syndrome is a known complication of coronary artery bypass grafts (CABG) using cardiopulmonary bypass (CB).
- Understanding the relationship between inflammatory markers and lung function post-CABG is crucial for optimizing patient outcomes.
Purpose:
- To evaluate systemic and pulmonary cytokine levels in patients undergoing myocardial revascularization (MR) with CB.
- To determine the correlation between these cytokine levels and lung function parameters.
Summary:
- Cytokine levels (IL-1β, IL-6, IL-8, IL-10, TNF-α) in plasma and bronchoalveolar lavage increased post-CB.
- Elevated IL-1β correlated with decreased lung compliance, while increased IL-10 showed an inverse relationship with compliance.
- IL-6 and IL-8 levels correlated with CB and surgery duration, respectively. Higher levels of IL-1β, IL-8, and TNF-α were found in bronchoalveolar lavage compared to plasma.
Impact:
- Findings highlight the inflammatory impact of CB on lung function.
- Correlations identified may aid in predicting and managing post-operative pulmonary complications in CABG patients.
- This study provides insights into the specific roles of different cytokines in the inflammatory response following cardiac surgery.
Background And Objectives:
Systemic inflammatory response syndrome is commonly observed in coronary artery bypass grafts (CABG) with cardiopulmonary bypass (CB). The objective of this study was to evaluate the systemic and pulmonary levels of cytokines and their correlation with lung function in patients undergoing myocardial revascularization (MR) with CB.
Methods:
This study was approved by the Institutional Ethics Committee, and 13 patients undergoing MR with CB were evaluated. After anesthetic induction and at the end of CB, plasma and bronchoalveolar lavage levels of IL-1β, IL-6, IL-8, IL-10, and TNF-α were determined. The duration of CB and surgery, PaO(2)/FiO(2) ratio, alveolar-arterial oxygen gradient (A-a gradient), shunt, and lung compliance were evaluated. Results were submitted to analysis of variance for repeated measurements (*p < 0.05) and Spearman's correlation coefficient.
Results:
We observed increased levels of cytokines in plasma and bronchoalveolar lavage after CB and a direct relationship between the increase in IL-1β and decrease in lung compliance (p = 0.0439), as well as the inverse relationship between the increase in IL-10 and a decrease in compliance (p = 0.0325). The increase in IL-6 was directly related to the duration of CB (p = 0.012), while the increase in IL-8 was directly related to the duration of surgery (p < 0.0001). Levels of interleukin-1β, IL-8, and TNF-α in bronchoalveolar lavage were higher than in plasma.
Conclusions:
There is an increase in cytokine levels in plasma and bronchoalveolar lavage after CB, as well as a correlation between increased cytokine levels and CB duration and surgery and changes in lung compliance.
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