Pump prime aprotinin fails to limit proinflammatory cytokine release aftercoronary artery bypass surgery

Background-The purpose of this study was to establish whether pump prime ap rotinin could limit the cytokine responses in patients undergoing elective coronary artery bypass surgery. Methods-Twenty-one patients admitted for first-time elective coronary arter y bypass surgery were randomized into control or aprotinin groups. Patients in the aprotinin group received 280 mg aprotinin in the pump prime. Leukoc yte count, creatine kinase cardiac isoenzyme (CK-MB), cytokine production a nd postoperative blood loss were analyzed perioperatively and compared with preoperative values. Results-The peak level of leukocyte count was lower in the aprotinin group than in controls (9.3 +/- 0.58 vs 11.2 +/- 0.68 x 10(9)/L, p = 0.01). Inter leukin (IL)-6 and IL-8 did not differ significantly between the groups thro ughout: the study period. Plasma IL-10 levels were higher in the controls t han in the aprotinin group at 5 min (49.6 +/- 24.9 vs 8.13 +/- 2.8 p g/ml, p = 0.01) after reperfusion. Conclusion-Pump prime aprotinin fails to limit proinflammatory cytokine res ponse in circulating blood.