PERIOPERATIVE CYTOKINE RELEASE DURING CORONARY-ARTERY BYPASS-GRAFTINGIN PATIENTS OF DIFFERENT AGES

Surgical interventions and cardiopulmonary bypass (CPB) induce a syste mic inflammatory response with cytokine release. Ageing is perceived a s a process of impaired immune functions: IL-1 beta, IL-6 and tumour n ecrosis factor-alpha (TNF-alpha) secretion are increased while IL-2 re lease is reduced in advanced age. At present, little information is av ailable about perioperative immune reactions at different stages of ag eing. The aim of the present study was to compare IL-6, IL-1 beta, TNF -alpha, IL-10 and soluble IL-2 receptor (sIL-2R) in younger and older patients undergoing cardiac surgery. Male patients (n = 14) undergoing elective coronary artery bypass grafting (CABG surgery employing CPB with moderate hypothermia were divided into two groups according to th eir age: group 1 included seven patients <50 years old, group 2 includ ed seven patients >65 years old. All patients received general anaesth esia using a balanced technique with sufentanil, isoflurane and midazo lam. Blood samples were collected preoperatively (T1); intra-operative ly during CPB (T2); post-operatively on the day of surgery (T3); on th e first post-operative day (T4). Blood concentrations of IL-6, IL-1 be ta, IL-10, TNF-alpha and sIL-2R were measured using commercially avail able ELISA kits and corrected for plasma cell volume. Statistical anal ysis was performed by non-parametric analysis of variance and Mann-Whi tney U-test. Significance level was set to P<0.05. There were no stati stically significant differences in the perioperative release of TNF-a lpha, IL-6, IL-1 beta, IL-10 and sIL-2R among the two groups. We concl ude that the perioperative course of cytokine release in patients unde rgoing CABG surgery with CPB and comparable perioperative management d oes not significantly differ in the two age groups.