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Comparison of hypertonic saline versus normal saline on cytokine profile during CABG
Mahnaz Mazandarani1, Fardin Yousefshahi, Mohammad Abdollahi
1Department of Pharmacotherapy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. mojtahed@sina.tums.ac.ir.
Insights
Pre-treatment with hypertonic saline (HS) 5% in coronary artery bypass grafting (CABG) patients may reduce inflammatory markers like IL-6. While not statistically significant, HS showed a trend toward lower IL-6 and higher IL-10 levels compared to normal saline (NS).
Area of Science:
- Cardiovascular Surgery
- Anesthesiology
- Critical Care Medicine
- Immunology
Background:
- Cardiopulmonary bypass (CPB) in Coronary Artery Bypass Grafting (CABG) can trigger systemic inflammation due to blood-artificial surface contact and ischemia-reperfusion injury.
- Hypertonic saline (HS) has emerged as a potential fluid to mitigate inflammatory responses and cytokine generation during cardiac surgery.
Purpose of the Study:
- To investigate the prophylactic effects of a 5% hypertonic saline (HS) infusion versus normal saline (NS) on inflammatory biomarkers in CABG patients.
- To assess serum Interleukin-6 (IL-6) as an inflammatory marker and Interleukin-10 (IL-10) as an anti-inflammatory marker.
Main Methods:
- A randomized, double-blinded clinical trial involving 40 patients undergoing CABG.
- Patients were randomized to receive either HS 5% or NS pre-operatively.
- Plasma levels of IL-6 and IL-10 were measured using ELISA at baseline, pre-operation, and 24 and 48 hours post-operatively.
Main Results:
- Patients receiving HS exhibited lower mean levels of IL-6 and higher mean levels of IL-10 compared to the NS group.
- These observed differences in IL-6 and IL-10 levels between the HS and NS groups did not reach statistical significance.
Conclusions:
- Pre-treatment with a small volume of 5% hypertonic saline may offer potential benefits in modulating the inflammatory response following CABG surgery.
- Further research with larger sample sizes is warranted to confirm the statistical significance and clinical impact of HS in this context.
Background And The Purpose Of The Study:
Blood contact with artificial surfaces of the extracorporeal circuit and ischemia-reperfusion injury in CABG with CPB, may lead to a systemic inflammatory response. Hypertonic saline have been recently investigated as a fluid in order to decrease inflammatory response and cytokines generation in patients undergo cardiac operations. Our purpose is to study the prophylactic effect of HS 5% infusion versus NS on serum IL-6 as an inflammatory & IL-10 as an anti-inflammatory biomarker in CABG patients.
Methods:
The present study is a randomized double-blinded clinical trial. 40 patients undergoing CABG were randomized to receive HS 5% or NS before operation. Blood samples were obtained after receiving HS or NS, just before operation, 24 and 48 hours post-operatively. Plasma levels of IL-6 and IL-10 were measured by ELISA.
Results And Major Conclusion:
Patients received HS had lower levels of IL-6 and higher level of IL-10 compared with NS group, however these differences were not statistically significant. Results of this study suggest that pre-treatment with small volume hypertonic saline 5% may have beneficial effects on inflammatory response following CABG operation.
