Authors: Minxin Wei Pekka Kuukasjärvi Jari Laurikka Seppo Kaukinen EvaLiisa Honkonen Riina Metsänoja Matti Tarkka
Publish Date: 2003/08/21
Volume: 27, Issue: 10, Pages: 1093-1098
Abstract
Hemodynamic instability is frequent after coronary surgery The present study tested the hypothesis that inflammation as determined by circulating cytokine levels may contribute to the difficulty of controlling arterial blood pressure after coronary artery bypass grafting A group of 44 male patients undergoing elective coronary artery bypass grafting with cardiopulmonary bypass were studied Plasma levels of tumor necrosis factorα interleukin6 IL6 IL8 and IL10 were measured before anesthesia induction 5 minutes and 1 hour after reperfusion to the myocardium and 2 and 18 hours after arriving in the intensive care unit ICU The 29 patients who did not need a vasopressor norepinephrine during their ICU stay were designated group I They were compared to group II which consisted of 15 patients who required a pressor agent in the ICU Although no significant differences between groups were found regarding their hemodynamic variables IL6 and IL8 levels were higher in the patients who used a pressor agent in the ICU The norepinephrine dosage used in the ICU correlated with plasma IL8 levels 2 hours after arriving in the ICU r = 056 p = 0031 Circulating IL6 levels in group II were significantly higher than those in group I 2 hours after arriving in the ICU 1265 ± 905 vs 665 ± 482 pg/ml p 005 The mean IL8 levels were higher in group II at 5 minutes 349 ± 257 vs 173 ± 113 pg/ml and 1 hour 386 ± 305 vs 224 ± 167 pg/ml after reperfusion and 2 hours 330 ± 216 vs 228 ± 167 pg/ml after arriving in the ICU p = 0036 Postoperative vasodilation was associated with increased circulating IL8 levels Strategies that modulate cytokine responses may improve hemodynamic stability after coronary artery bypass grafting
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