1. Low tidal volume ventilation during cardiopulmonary bypass reduces postoperative chemokine serum concentrations.
- Author
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Beer L, Szerafin T, Mitterbauer A, Debreceni T, Maros T, Dworschak M, Roth GA, and Ankersmit HJ
- Subjects
- Aged, Aged, 80 and over, Austria, Biomarkers blood, Chemokine CCL2 blood, Chemokine CCL20 blood, Chemokine CCL4 blood, Down-Regulation, Female, Humans, Male, Middle Aged, Systemic Inflammatory Response Syndrome diagnosis, Systemic Inflammatory Response Syndrome etiology, Time Factors, Treatment Outcome, Cardiopulmonary Bypass adverse effects, Chemokines blood, Coronary Artery Bypass adverse effects, Respiration, Artificial methods, Systemic Inflammatory Response Syndrome blood, Tidal Volume
- Abstract
Background: Open-heart surgery with cardiopulmonary bypass (CPB) is associated with a generalized immune response and postoperative lung dysfunction. Chemokines are involved in the pathogenesis of postoperative lung dysfunction. We investigated whether continued mechanical ventilation during CPB has an impact on chemokine serum concentrations., Methods: A total of 30 patients undergoing coronary artery bypass graft operation were randomized to either continuous ventilated group (n=15) or nonventilated group (n=15). Blood samples were drawn at the beginning and at the end of surgery and on the 5 consecutive days. Serum CCL2, CCL4, and CCL20 concentrations were measured and given as mean ± standard deviation., Results: Chemokine concentrations were elevated at the end of surgery in both groups. CCL2 and CCL4 levels returned to baseline on postoperative day (POD)-1 in the ventilation group and stayed elevated in the nonventilation group. CCL4 serum levels were significantly lower in ventilated-group patients on POD-1 (10.9 [39.0] vs. 153.2 [168.1]; p=0.005), POD-2 (16.8 [36.8] vs. 147.9 [165.4]; p=0.019), POD-3 (14.2 [24.0] vs. 97.9 [87.1]; p=0.005), and POD-5 (6.5 [25.0] vs. 33.6 [38.4]; p=0.045)., Conclusion: Continued mechanical ventilation during CPB results in reduced CCL4 concentrations on POD-1 to -5., (Georg Thieme Verlag KG Stuttgart · New York.)
- Published
- 2014
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