[Influence of cardiopulmonary bypass on biological response]

To investigate the influence of cardiopulmonary bypass (CPB) on biological response, we measured the serum level of tumor necrosis factor-alpha (TNF-alpha), interleukin-1beta (IL-1beta), and granulocyte elastase (GEL) in 24 patients who underwent elective cardiac surgery and 32 patients who underwent elective gastroenterological surgery. All patients were alive. The serum level of GEL in cardiac patients was significantly higher than that in gastroenterological patients on the 1st and the 3rd postoperative day (P = 0.00008, P = 0.00097 respectively). In addition. there was a significant relationship between CPB time and the serum level of GEL immediately after CPB (r = 0.53, P = 0. 007). That is a reason why higher level of serum GEL in cardiac surgery is due to the bacterial translocation. TNF-alpha and IL-1beta were detected in only :3 patients who underwent over 250 minutes CPB. It is most important to shorten the CPB time in order to decrease the serum GEL and lessen the biological response surgery.