THE ROLE OF CYTOKINES IN CARDIAC-SURGERY

Cytokines are a large and rapidly expanding group of polypeptides prod uced by many diferent cell types. Increasing interest has been focused on the role of cytokines as mediators of metabolic, immunological and endocrine responses to surgery. The cytokine response in patients und ergoing cardiac surgery during cardiopulmonary bypass (CPB) is fairly well-defined and dominated by the proinflammatory cytokines IL-6, TNF alpha and IL-8 and the antiinflammatory cytokine IL-10. Little is know n about the cytokine response in patients who develop postoperative co mplications but CPB with mechanical trauma and blood contact to artifi cial membranes is definitely an unphysiological state and may contribu te to an uncontrollable response similar to that of patients with mult iorgan failure and septic shock.