Background Peripheral vasodilation, a potentially adverse effect of wa
rm heart surgery, may be mediated by the perioperative release of cyto
kines. Corticosteroids may abolish cytokine production and vasodilatio
n. We investigated cytokine production and its inhibition by steroids
in patients undergoing elective coronary bypass surgery. Methods and R
esults Twenty-five patients undergoing coronary bypass surgery with no
rmothermic cardiopulmonary bypass received either preoperative steroid
(Solumedrol 250 mg IV, n=16) or no steroid (n=9, control group). Bloo
d samples were obtained serially for 24 hours and assayed for interleu
kin-6 (IL-6), tumor necrosis factor (TNF), and interleukin-8 (IL-8). I
n the control patients, the IL-6, TNF, and IL-8 levels were elevated p
ostoperatively and peaked between 3 and 6 hours after surgery (IL-6, 1
330+/-295 [mean+/-SEM] pg/mL; TNF, 18.4+/-9.8 pg/mL; and IL-S, 150+/-5
1 pg/mL). Cytokine release was abolished in patients receiving preoper
ative corticosteroid (IL-6, 75+/-38 pg/mL; TNF, 2.6+/-0.5 pg/mL; and I
L-8, 33+/-6.7 pg/mL; P<.05). Patients receiving steroid premedication
had higher arterial pressure, lower cardiac index, and higher systemic
vascular resistance, indicating less vasodilation. Conclusions Our fi
ndings demonstrate that cytokine production occurs after normothermic
cardiopulmonary bypass. Preoperative administration of steroids abolis
hes cytokine release and vasodilation.