[Responses of TNF alpha, IL-8, and leukocyte adhesion molecule CD18 to cardiopulmonary bypass]

To evaluate the inflammatory response to the cardiopulmonary bypass, we investigated the serum levels of tumor necrosis factor alpha (TNF alpha), interleukin 8 (IL-8), and the expression of leukocyte adhesion molecule CD18. Six patients who underwent elective coronary artery bypass grafting were studied. TNF alpha was elevated significantly 30 minutes after the start of CPB and returned to the baseline 60 minutes after CPB. IL-8 increased significantly after the start of CPB and reached a peak at 10 minutes after release of the aortic cross-clamp, remaining significantly elevated until 10 minutes after the end of CPB (P < 0.05). Circulating neutrophil count and granulocyte elastase increased significantly 10 minutes after release of the aortic-cross clamp and remained high until the first postoperative day. The increase of the neutrophil CD18 expression was not observed. This study demonstrates elevated TNF alpha and IL-8 levels during CPB followed by increases of the neutrophil and the granulocyte elastase, which may be of importance in the systemic inflammatory response to CPB, especially in the development of postperfusion lung injury.