Comparison of inflammatory response during on-pump and off-pump coronary artery bypass surgery

Int J Artif Organs. 2010 Mar;33(3):131-8. doi: 10.1177/039139881003300301.

Abstract

Purpose: On-pump coronary artery bypass graft (CABG) surgery has been traditionally associated with a higher magnitude of inflammatory response than off-pump CABG. However with the development of polymer-coated biocompatible extracorporeal circuits, we wanted to see if cardiopulmonary bypass still played an important role in triggering this inflammatory response.

Methods: In this prospective observational study, 33 patients undergoing CABG surgeries (25 on-pump and 8 off-pump patients) were studied. Serial plasma cytokine (TNF IL-6, IL-10) and procalcitonin concentrations were measured at different time-points during and after the surgery. Demographic and baseline clinical data, intra-operative management details and post-operative complications were also collected from the patients' charts.

Results: Plasma levels of all 4 mediators increased during surgery and returned towards normal postoperatively. There were no differences between groups for any mediator at any time-point.

Conclusions: We conclude that with the use of recent polymer-coated biocompatible extracorporeal circuits, the inflammatory response triggered by on-pump CABG becomes very similar in magnitude and pattern to that triggered by off-pump CABG. Thus, the surgical procedure contributes to most of the inflammatory response, with the extra-corporeal circuit having minimal to no effect on this response.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Calcitonin / blood
  • Calcitonin Gene-Related Peptide
  • Coated Materials, Biocompatible / adverse effects*
  • Coronary Artery Bypass, Off-Pump / adverse effects*
  • Cytokines / blood
  • Female
  • Humans
  • Inflammation / blood
  • Inflammation / etiology*
  • Male
  • Middle Aged
  • Prospective Studies
  • Protein Precursors / blood

Substances

  • CALCA protein, human
  • Coated Materials, Biocompatible
  • Cytokines
  • Protein Precursors
  • Calcitonin
  • Calcitonin Gene-Related Peptide