Alterations in the number of circulating leucocytes, phenotype of monocyteand cytokine production in patients undergoing cardiothoracic surgery

Changes in the differential blood cell count, monocyte phenotype and the cy tokine plasma levels in a group of seven patients with cardiac surgery/card iopulmonary bypass (CPB) and nine patients with thoracic surgery/without CP B, both receiving identical opioid-based anaesthetic technique, were assess ed. A significant reduction in the number of circulating lymphocytes and mo nocytes was observed after anaesthesia and surgery. Interestingly, at the e nd of surgery as well as 1 day post-surgery a marked increase in the number of granulocytes was noted. General anaesthesia and surgery caused a signif icant reduction of HLA-DR and CD11c/CD18 molecules, starting immediately af ter induction of anaesthesia, and an increase of CD64 at day 1 after anaest hesia. The use of a CPB was followed by a significant reduction of CD32, CD 16, CD54 and HLA-ABC antigens expression at the end of surgery. One day aft er surgery these parameters returned nearly to baseline values with the exc eption of CD54. A monocyte subpopulation, characterized by low CD14, high C D16 and HLA-DR expression (CD14(+)CD16(+)HLA-DR++) was found in both groups at each time point, and the percentage of this cell subset decreased from baseline to 24 h. The plasma concentrations of IL-6 and IL-10 increased con siderably during CPB. No dynamic changes of IL-1 level due to surgery or CP B were found. We conclude that anaesthesia as well as the use of CPB induce d profound alterations in the number of circulating leucocytes, and in the phenotype of monocyte and cytokine production.