BACKGROUND: The role of a cell-saver device in the inflammatory response to cardiac surgery has not been well documented. We hypothesized that the use of a cell saver may reduce proinflammatory cytokine concentrations in patients undergoing cardiac surgery. METHODS:57 patients presenting for first-time nonemergency cardiac surgery were prospectively randomized to control or cell salvage groups. Blood samples for inflammatory marker assays were collected from the arterial line on induction of anesthesia, at the end of cardiopulmonary bypass, 1 h after surgery, and 24 h after surgery. Plasma proinflammatory cytokines were analyzed using a sandwich solid-phase enzyme-linked immunosorbent assay. RESULTS: The highest cytokine levels were observed 1 h after surgery. When comparing serum interleukin levels in both patient groups during the different perioperative periods, we found a higher interleukin-8 concentration 24 h after the procedure, and higher concentrations of the p40 subunit of interleukin-12 at 1 h and 24 h postoperatively. The concentrations of interleukin-6 and p40 were greater in blood stored by the cardiotomy suction system than in blood processed by the cell saver (p = 0.01 in both cases). The interleukin-8 concentration was higher in the blood processed by the cell saver (p = 0.03). No significant differences were observed in interleukin-1 and interferon gamma levels in blood from both systems. Clinical outcomes were similar in both groups. CONCLUSIONS: Our results suggest that cell salvage in low-risk patients undergoing their first elective cardiac procedure does not decrease the inflammatory response after surgery.
RCT Entities:
BACKGROUND: The role of a cell-saver device in the inflammatory response to cardiac surgery has not been well documented. We hypothesized that the use of a cell saver may reduce proinflammatory cytokine concentrations in patients undergoing cardiac surgery. METHODS: 57 patients presenting for first-time nonemergency cardiac surgery were prospectively randomized to control or cell salvage groups. Blood samples for inflammatory marker assays were collected from the arterial line on induction of anesthesia, at the end of cardiopulmonary bypass, 1 h after surgery, and 24 h after surgery. Plasma proinflammatory cytokines were analyzed using a sandwich solid-phase enzyme-linked immunosorbent assay. RESULTS: The highest cytokine levels were observed 1 h after surgery. When comparing serum interleukin levels in both patient groups during the different perioperative periods, we found a higher interleukin-8 concentration 24 h after the procedure, and higher concentrations of the p40 subunit of interleukin-12 at 1 h and 24 h postoperatively. The concentrations of interleukin-6 and p40 were greater in blood stored by the cardiotomy suction system than in blood processed by the cell saver (p = 0.01 in both cases). The interleukin-8 concentration was higher in the blood processed by the cell saver (p = 0.03). No significant differences were observed in interleukin-1 and interferon gamma levels in blood from both systems. Clinical outcomes were similar in both groups. CONCLUSIONS: Our results suggest that cell salvage in low-risk patients undergoing their first elective cardiac procedure does not decrease the inflammatory response after surgery.
Authors: Jill M Cholette; Anthony P Pietropaoli; Kelly F Henrichs; George M Alfieris; Karen S Powers; Richard Phipps; Sherry L Spinelli; Michael Swartz; Francisco Gensini; L Eugene Daugherty; Emily Nazarian; Jeffrey S Rubenstein; Dawn Sweeney; Michael Eaton; Neil Blumberg Journal: Pediatr Crit Care Med Date: 2015-03 Impact factor: 3.624
Authors: Emmanuel Akintoye; Jason H Y Wu; Tao Hou; Xiaoling Song; Jun Yang; Bruce Hammock; Dariush Mozaffarian Journal: J Lipid Res Date: 2016-01-09 Impact factor: 5.922
Authors: Gerda A Zeilmaker-Roest; Annewil van Saet; Joost van Rosmalen; Soma Bahmany; Antony van Dijk; Enno D Wildschut; Dick Tibboel; Ad J J C Bogers Journal: J Cardiothorac Surg Date: 2018-06-08 Impact factor: 1.637