Oxygenation and release of inflammatory mediators after off-pump compared with after on-pump coronary artery bypass surgery

  1. B. S. Rasmussen*,
  2. H. Laugesen,
  3. J. Sollid,
  4. J. Grønlund,
  5. S. E. Rees,
  6. E. Toft,
  7. J. Gjedsted,
  8. C. Dethlefsen,
  9. E. Tønnesen

Article first published online: 10 SEP 2007

DOI: 10.1111/j.1399-6576.2007.01426.x

Issue

Acta Anaesthesiologica Scandinavica

Acta Anaesthesiologica Scandinavica

Volume 51, Issue 9, pages 1202–1210, October 2007

Additional Information

How to Cite

Rasmussen, B. S., Laugesen, H., Sollid, J., Grønlund, J., Rees, S. E., Toft, E., Gjedsted, J., Dethlefsen, C. and Tønnesen, E. (2007), Oxygenation and release of inflammatory mediators after off-pump compared with after on-pump coronary artery bypass surgery. Acta Anaesthesiologica Scandinavica, 51: 1202–1210. doi: 10.1111/j.1399-6576.2007.01426.x

Author Information

  1. Departments of 1Anaesthesia and2Cardiothoracic Surgery, Center for Cardiovascular Research, Aalborg Hospital, Aarhus University Hospital , 3Center for Model based Medical Decision Support, Department of Health Science and Technology, Aalborg University , 4Department of Cardiology Center for Cardiovascular Research, Aalborg Hospital, Aarhus University Hospital , 5Sensory–Motor Interaction (SMI) and 6Department of Anesthesia, Aarhus University Hospital and 7Biostatistical Unit, Center for Cardiovascular Research, Aalborg Hospital, Aarhus University Hospital, Denmark

*Bodil Steen Rasmussen Department of Anaesthesia Aalborg Hospital Aarhus University Hospital Hobrovej 18–22 DK-9100 Aalborg Denmark e-mail: bodil.steen.rasmussen@rn.dk

Publication History

  1. Issue published online: 10 SEP 2007
  2. Article first published online: 10 SEP 2007
  3. Accepted for publication 19 May 2007

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Keywords:

  • coronary artery bypass;
  • cytokines;
  • pulmonary gas exchange;
  • randomized clinical trial

Background:  In a previous study, we showed that oxygenation was impaired for up to 5 day after conventional coronary artery bypass grafting (CABG). As cardiopulmonary bypass (CPB) may have a detrimental effect on pulmonary function, we hypothesized that coronary revascularization grafting without the use of CPB (OPCAB) would affect post-operative oxygenation and release of inflammatory mediators less compared with CABG.

Methods:  Low-risk patients scheduled for elective coronary revascularization were randomly assigned to one of two groups (CABG, n = 17 or OPCAB, n = 18). Two parameters of oxygenation, shunt (%) and ventilation-perfusions mismatch, described as ΔPO2 (kPa), were estimated for up to 5 days post-operatively. Systemic release of interleukin (IL)-6, -8 and -10, C-reactive protein (CRP) and neutrophils were measured in peripheral blood samples for up to 3 days post-operatively. The lungs participation in the cytokine response was evaluated from mixed venous blood samples taken within the first 16 h post-operatively.

Results:  OPCAB was followed by a higher shunt (P = 0.047), with no difference (P = 0.47) in the deterioration of ΔPO2 between the groups. OPCAB was followed by an attenuated systemic release of IL-8 (P = 0.041) and IL-10 (P = 0.006), while the release of IL-6 (P = 0.94), CRP (P = 0.121) and neutrophils (P = 0.078) did not differ between the groups. Indications of an uptake of cytokines in the lungs were found after OPCAB.

Conclusions:  When comparing OPCAB with CABG, oxygenation was more affected and only part of the systemic inflammatory response was attenuated.

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