Effect of protective lung ventilation during cardiopulmonary bypass on serum procalcitonin and interleukin- 6 concentrations in coronary artery bypass grafting patients

Abstract

Objective: Evaluation of changes in serum Interleukin-6 and pro-calcitonin levels in patients who underwent coronary artery bypass grafting with and without protective lung ventilation during cardiopulmonary bypass.
 Methods: Randomised controlled trial. Eighty patients subjected to coronary bypass surgery were prospectively randomised to two groups: protective lung ventilation and no ventilation, during cardiopulmonary bypass. Serum interleukins - 6 levels were studied before and at6 hours, 24 hours, 48 hours and 72 hoursafter the cardiac surgery. Similarly, we also have measured serum procalcitonin (PCT) concentrations before and 24 hours after surgery.
 Results: The serum levels of Interleukin 6 (IL-6) increased with time, peaked six hours after cardiac surgery and levels were higher in the non-ventilated group when compared with the protective lung ventilation group at 6 hours (362,09 ± 91.52 vs 306,16 ± 73.99 ; p<0.05) and 24 hours (256,5 ± 100,64 vs 204, 44 ± 52.59 ) after coronary artery bypass graft (CABG) operation. In addition, the secretion of pro-calcitonin after 24 hours surgery was significanly reduced in the ventilated patients compared to no ventilation patients (1.858 ± 4,205vs 4,302 ± 10,68; p< 0.05).
 Conclusion: The protective mechanical ventilation during cardiopulmonary bypass may decrease serum IL-6 and procalcitonin concentrations after CABG.