Cerebrovascular cytokine responses during coronary artery bypass surgery: Specific production of interleukin-8 and its attenuation by hypothermic cardiopulmonary bypass
K. Nandate et al., Cerebrovascular cytokine responses during coronary artery bypass surgery: Specific production of interleukin-8 and its attenuation by hypothermic cardiopulmonary bypass, ANESTH ANAL, 89(4), 1999, pp. 823-828
Citations number
25
Categorie Soggetti
Aneshtesia & Intensive Care","Medical Research Diagnosis & Treatment
Brain dysfunction after cardiopulmonary bypass (CPB) is common, and it has
been hypothesized that this injury might be due partly to activation of inf
lammatory processes in the brain. We measured juguloarterial gradients for
interleukin-1 beta, interleukin-6, and interleukin-8 (IL-8) as indices of l
ocal proinflammatory cytokine production in the brain and studied the effec
t of temperature during CPB on these changes. Twelve patients undergoing co
ronary artery bypass graft surgery (normothermic CPB n = 6, hypothermic CPB
n = 6) were studied. Cytokine levels were measured in paired arterial and
jugular bulb samples obtained before, during, and after CPB. Although syste
mic levels of all three cytokines increased during and after CPB, increases
in juguloarterial cytokine gradients were observed only for IL-8. Juguloar
terial IL-8 gradients started to increase 1 h post-CPB and were significant
ly elevated 6 h post-CPB (P < 0.05). At this time point, the median (interq
uartile range) juguloarterial IL-8 gradients were significantly larger in t
he normothermic CPB group (25.81 [24.49-39.51] pg/mL) compared with the hyp
othermic CPB group (6.69 [-0.04 to 15.47] pg/mL; P < 0.05). These data impl
y specific and significant IL-8 production in the cerebrovascular bed durin
g CPB and suggest that these changes may be suppressed by hypothermia durin
g CPB. Implications: Using juguloarterial gradients to measure cerebrovascu
lar cytokine production is novel in the setting of cardiopulmonary bypass a
nd implicates the cerebral activation of inflammatory processes, which may
contribute to brain dysfunction. Hypothermia during cardiopulmonary bypass
may significantly attenuate this response.