Inflammatory response to cardiopulmonary bypass using roller or centrifugal pumps

Background. The inflammatory response in 29 patients undergoing coronary ar tery bypass grafting using either roller or centrifugal (CFP) pumps was eva luated in a prospective study. Methods. Patients were randomized in roller pump (n = 15) and CFP (n = 14) groups. Terminal complement complex activation (SC5b-9) and neutrophil acti vation (elastase) were assessed during the operation. Cytokine production ( tumor necrosis factor-alpha interleukin-6, interleukin-8) and circulating a dhesion molecules (soluble endothelial-leukocyte adhesion molecule-1 and in tercellular adhesion molecule-1) were assessed after the operation. Results. Release of SC5b-9 after stopping cardiopulmonary bypass and after protamine administration was higher in the CFP group (p = 0.01 and p = 0.00 4). Elastase level was higher after stopping cardiopulmonary bypass using C FP (p = 0.006). Multivariate analysis confirmed differences between roller pump and CFP groups in complement and neutrophil activation. After the oper ation, a significant production of cytokines was detected similarly in both groups, with peak values observed within the range of 4 to 6 hours after s tarting cardiopulmonary bypass. However, interleukin-8 levels were higher u sing CFP 2 hours after starting cardiopulmonary bypass (p = 0.02). Plasma l evels of adhesion molecules were similar in both groups within the investig ation period. Conclusions. During the operation, CFP caused greater complement and neutro phil activation. After the operation, the inflammatory response was similar using either roller pump or CFP. (Ann Thorac Surg 1999;67:972-7) (C) 1999 by The Society of Thoracic Surgeons.