BACKGROUND: It is well known that conventional coronary revascularization is associated with a pronounced systemic inflammatory response due to the application of cardiopulmonary bypass (CPB). OBJECTIVE: To compare the effects of coronary artery bypass grafting (CABG) with (on-pump) or without (off-pump) extra-corporeal circulation observing certain inflammatory response parameters. METHODS: TWENTY PATIENTS UNDERGOING CABG WITH (CPB GROUP: 10 patients) or without (off-pump coronary artery bypass grafting [OPCAB] group: 10 patients) CPB were enrolled in this prospective, randomized study. Blood samples were collected three times during the operation and on postoperative days 1, 2, 3 and 7. The plasma level of proinflammatory cytokine tumor necrosis factor (TNF)-alpha was measured by enzyme-linked immunosorbent assay method following stimulation, and the expression of adhesion molecules (CD11, CD18) of leukocytes were determined by flow cytometry. Furthermore, white blood cell (WBC) and neutrophil count were carried out. RESULTS: The WBC and neutrophil counts rose markedly in both groups following the operation and remained at this increased level during the observation period. There was a significant difference in WBC and neutrophil counts between the two groups of patients on postoperative day 7. A significant difference in the level of TNF-alpha was found between the two groups on postoperative day 2 (P<0.05). An intense increase was observed with CPB, which significantly exceeded the values of the OPCAB group without extracorporeal circulation in the early postoperative period. The CD11a and CD18 expression of leukocytes decreased during the operation and on postoperative day 1; thereafter, it increased markedly. There was a significant difference in adhesion molecule expression between the two groups on postoperative day 2. CONCLUSION: The investigation revealed that inflammatory response reactions following extracorporeal circulation could be reduced significantly using the off-pump technique.
RCT Entities:
BACKGROUND: It is well known that conventional coronary revascularization is associated with a pronounced systemic inflammatory response due to the application of cardiopulmonary bypass (CPB). OBJECTIVE: To compare the effects of coronary artery bypass grafting (CABG) with (on-pump) or without (off-pump) extra-corporeal circulation observing certain inflammatory response parameters. METHODS: TWENTY PATIENTS UNDERGOING CABG WITH (CPB GROUP: 10 patients) or without (off-pump coronary artery bypass grafting [OPCAB] group: 10 patients) CPB were enrolled in this prospective, randomized study. Blood samples were collected three times during the operation and on postoperative days 1, 2, 3 and 7. The plasma level of proinflammatory cytokine tumor necrosis factor (TNF)-alpha was measured by enzyme-linked immunosorbent assay method following stimulation, and the expression of adhesion molecules (CD11, CD18) of leukocytes were determined by flow cytometry. Furthermore, white blood cell (WBC) and neutrophil count were carried out. RESULTS: The WBC and neutrophil counts rose markedly in both groups following the operation and remained at this increased level during the observation period. There was a significant difference in WBC and neutrophil counts between the two groups of patients on postoperative day 7. A significant difference in the level of TNF-alpha was found between the two groups on postoperative day 2 (P<0.05). An intense increase was observed with CPB, which significantly exceeded the values of the OPCAB group without extracorporeal circulation in the early postoperative period. The CD11a and CD18 expression of leukocytes decreased during the operation and on postoperative day 1; thereafter, it increased markedly. There was a significant difference in adhesion molecule expression between the two groups on postoperative day 2. CONCLUSION: The investigation revealed that inflammatory response reactions following extracorporeal circulation could be reduced significantly using the off-pump technique.
Authors: Sharif Al-Ruzzeh; Gareth Ambler; George Asimakopoulos; Rumana Z Omar; Ragheb Hasan; Brian Fabri; Ahmed El-Gamel; Anthony DeSouza; Vipin Zamvar; Steven Griffin; Daniel Keenan; Uday Trivedi; Mark Pullan; Alex Cale; Michael Cowen; Kenneth Taylor; Mohamed Amrani Journal: Circulation Date: 2003-09-09 Impact factor: 29.690
Authors: M Strüber; J T Cremer; B Gohrbandt; C Hagl; M Jankowski; B Völker; H Rückoldt; M Martin; A Haverich Journal: Ann Thorac Surg Date: 1999-10 Impact factor: 4.330
Authors: C Schulze; N Conrad; A Schütz; K Egi; H Reichenspurner; B Reichart; S M Wildhirt Journal: Thorac Cardiovasc Surg Date: 2000-12 Impact factor: 1.827
Authors: Jan Bucerius; Jan F Gummert; Thomas Walther; Nicolas Doll; Volkmar Falk; Dierk V Schmitt; Friedrich W Mohr Journal: Intensive Care Med Date: 2003-09-20 Impact factor: 17.440
Authors: J P Gott; W A Cooper; F E Schmidt; W M Brown; C E Wright; J D Merlino; J D Fortenberry; W S Clark; R A Guyton Journal: Ann Thorac Surg Date: 1998-09 Impact factor: 4.330