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Related Experiment Videos

Systemic inflammation present in patients undergoing CABG without extracorporeal circulation

E Fransen1, J Maessen, M Dentener

  • 1Department of Cardiopulmonary Surgery, University Hospital Maastricht, The Netherlands.

Chest
|May 22, 1998
PubMed
Summary

Coronary artery bypass grafting (CABG) surgery causes systemic inflammation, not cardiopulmonary bypass (CPB). Neutrophil activation occurs only with CPB, indicating the surgical procedure itself drives the acute phase response.

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Area of Science:

  • Cardiovascular Surgery
  • Immunology
  • Anesthesiology

Background:

  • The systemic inflammatory response after coronary artery bypass grafting (CABG) is often attributed to cardiopulmonary bypass (CPB).
  • Understanding the specific contributors to inflammation is crucial for optimizing patient outcomes.

Purpose of the Study:

  • To investigate the extent to which cardiopulmonary bypass (CPB) contributes to the systemic inflammatory response in patients undergoing coronary artery bypass grafting (CABG).
  • To differentiate the inflammatory effects of the surgical procedure from those of extracorporeal circulation.

Main Methods:

  • Prospective study involving 16 patients undergoing elective CABG, divided into CPB and non-CPB groups.
  • Measurement of bactericidal permeability increasing protein (BPI), interleukin-6, lipopolysaccharide binding protein, and C-reactive protein.

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  • Serial blood sampling throughout the surgical procedure and post-operatively.

    • Main Results:

    • Bactericidal permeability increasing protein (BPI) release from neutrophils significantly increased in patients undergoing CPB, but not in the non-CPB group.
    • The increase in acute phase reactants (interleukin-6, lipopolysaccharide binding protein, C-reactive protein) was comparable in both CPB and non-CPB groups.

    Conclusions:

    • The acute phase response in CABG patients is primarily driven by the surgical procedure itself, rather than the cardiopulmonary bypass (CPB) technique.
    • Early neutrophil activation is specifically associated with the use of extracorporeal circulation (CPB).