Plasma levels of selectins and interleukins in cardiovascular surgery using cardiopulmonary bypass

Background: Cardiovascular surgery with cardiopulmonary bypass (CPB) leads to activation of a variety of inflammatory pathways, including the release of cytokines and selectins. Methods: In 20 patients undergoing elective cor onary artery bypass grafting, plasma levels of interleukins IL-2, -6, -8, - 10, -12 and of P-, E-, and L-selectins were measured at eight time points b efore, during, and after CPB using a standardized ELISA technique. Results: IL-2 plasma levels decreased significantly after the start of CPB and rema ined low until the second postoperative day. IL-6 and IL-8 levels increased significantly after weaning off CPB, with mean peak values six hours posto peratively. Very low IL-10 plasma levels were detectable preoperatively. Th ey remained low during CPB and peaked significantly after weaning off CPB u ntil skin closure. The IL-12 levels decreased after weaning off CPB (p<0.05 ) until 6 hours postoperatively, The plasma levels of P-selectin showed no alterations, but concentrations of E- and L-selectin decreased after the st art of CPB (p<0.05). There were no adverse postoperative events. Conclusion s: The results of our study demonstrate a dysregulation of cytokine and sel ectin production during and up to 48 h after CPB, which may be a "normal" s tress reaction to CPB.