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Published on: January 28, 2020
Inflammatory Biomarkers and Blood Physical Property Transformations Following On-Pump Coronary Artery Bypass Graft
Po-Shun Hsu1, Jia-Lin Chen2, Shih-Ying Sung1
1Division of Cardiovascular Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114202, Taiwan.
Insights
Coronary artery bypass graft (CABG) surgery leads to increased blood viscosity and inflammation for nearly a week post-operation. Understanding these hemorheological changes is key for improving patient recovery and outcomes.
Area of Science:
- Cardiovascular Surgery
- Hemodynamics
- Inflammation Biology
Background:
- Coronary artery bypass graft (CABG) surgery involves complex physiological changes.
- Factors like hypothermia and hemodilution can impact blood viscosity and inflammation during CABG.
- Postoperative hemorheological alterations require thorough investigation.
Purpose of the Study:
- To compare hemorheological and inflammatory changes before and after CABG surgery.
- To analyze the relationship between blood viscosity and inflammatory markers post-CABG.
- To understand the duration of these changes in the postoperative period.
Main Methods:
- 25 patients undergoing CABG surgery were studied.
- Whole blood viscosity (WBV) and plasma viscosity (PV) were measured at multiple time points (pre-surgery, 2 days post, 5 days post).
- Inflammatory markers (CRP, WBC, platelets, fibrinogen) were assessed and correlated with hemorheological data.
Main Results:
- Significant increases in PV were observed by day 5 post-CABG.
- WBV significantly increased on day 2 and day 5 after surgery.
- WBV correlated significantly with fibrinogen levels on days 2 and 5, with notable inflammatory marker changes.
Conclusions:
- Hyperviscosity, indicated by elevated PV and WBV, persists for nearly a week after on-pump CABG.
- The interplay between inflammation and hemorheological properties is critical in the postoperative phase.
- Further research is needed to explore mechanisms and interventions to mitigate inflammation's impact on blood viscosity post-CABG.
Objective:
This study aimed to compare the hemorheological and inflammatory changes before and after coronary artery bypass graft (CABG) surgery, as factors such as hypothermia, hemodilution, transfusion, and other variables affect blood viscosity and inflammation during the procedure.
Methods:
A total of 25 patients who underwent CABG surgery were enrolled in this study. Whole blood was collected just before the CABG (D0), 2 days after surgery (D2), and 5 days after surgery (D5). The plasma viscosity (PV) and whole blood viscosity (WBV) were measured at shear rates ranging from 0.1 to 1000 s-1 using a rheometer, and the mean values were compared. Inflammatory markers were also assessed and analyzed in relation to the hemorheological changes.
Results:
Compared with the baseline values, the PV significantly increased after 5 days. WBV showed a significant increase on day 2 and after 5 days. The WBV and fibrinogen were significantly correlated on day 2 and day 5 but not before surgery. Inflammatory markers such as CRP, WBC, platelets, and fibrinogen also demonstrated notable changes in relation to the hemorheological alterations.
Conclusions:
This study highlights the crucial finding that hyperviscosity, characterized by elevated PV and WBV, persists for almost one week after on-pump CABG surgery. Understanding the interplay between inflammation and hemorheological properties during the postoperative period is crucial for optimizing patient care. Future research should focus on exploring the underlying mechanisms and potential therapeutic interventions to mitigate the impact of inflammation on blood viscosity and improve patient outcomes following CABG surgery.
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