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Impact of minimal invasive extracorporeal circulation on systemic inflammatory response – a randomized trial.
- Source :
-
Journal of Cardiothoracic Surgery . 7/3/2024, Vol. 19 Issue 1, p1-9. 9p. - Publication Year :
- 2024
-
Abstract
- Background: Extracorporeal circulation causes a systemic inflammatory response, that may cause postoperative haemodynamic instability and end-organ dysfunction. This study aimed to investigate the impact of minimal invasive extracorporeal circulation (MiECC) on the systemic inflammatory response compared with conventional extracorporeal circulation (CECC). Methods: Patients undergoing coronary artery bypass grafting were randomized to MiECC (n = 30) and CECC (n = 30). Primary endpoint was tumor necrosis factor-α. Secondary endpoints were other biochemical markers of inflammation (IL1β, IL6 and IL8, C-reactive protein, leukocytes), and markers of inadequate tissue perfusion and tissue damage (lactate dehydrogenase, lactate and creatine kinase-MB). In addition, we registered signs of systemic inflammatory response syndrome, haemodynamic instability, atrial fibrillation, respiratory dysfunction, and infection. Results: Patients treated with MiECC showed significantly lower levels of tumor necrosis factor-α than CECC during and early after extracorporeal circulation (median: MiECC 3.4 pg/mL; CI 2.2–4.5 vs. CECC 4.6 pg/mL; CI 3.4–5.6; p = 0.01). Lower levels of creatine kinase-MB and lactate dehydrogenase suggested less tissue damage. However, we detected no other significant differences in any other markers of inflammation, tissue damage or in any of the clinical outcomes. Conclusions: Lower levels of TNF-α after MiECC compared with CECC may reflect reduced inflammatory response, although other biochemical markers of inflammation were comparable. Our results suggest better end-organ protection with MiECC compared with CECC. Clinical parameters related to systemic inflammatory response were comparable in this study. Clinical registration number: NCT03216720. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 17498090
- Volume :
- 19
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- Journal of Cardiothoracic Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 178276608
- Full Text :
- https://doi.org/10.1186/s13019-024-02903-8