Relationship Between Respiratory Distress and Cytokine Response after Cardiopulmonary Bypass

Abstract

The influence of cytokines on the inflammatory response in surgery has recently been the subject of investigations. We measured tumor necrotic factor-alpha (TNF-alpha), interleukin 1 beta (IL-1 beta), interleukin 6 (IL-6), interleukin 8 (IL-8), and granulocyte elastase (GEL) in 26 patients undergoing elective cardiac operations using cardiopulmonary bypass (CPB), preoperatively, immediately after CPB, and on post-operative days (PODs) 1, 3, and 6. To evaluate the effect of these cytokines on pulmonary function, the patients were divided according to whether the oxygenation index (OI) on POD 1 was > 250 or < 250, into groups A and B, respectively. TNF-alpha and IL-1 beta were undetectable and there were no significant differences in the preoperative IL-6, IL-8, and GEL levels. However, immediately following CPB, the mean IL-6, IL-8 and GEL levels in both groups were significantly higher than the preoperative levels (P < 0.01). Moreover, all these levels were significantly higher in group B than in group A, at 162 +/- 150 pg/ml vs 64 +/- 53 pg/ml (P < 0.05) for IL-6; 53 +/- pg/ ml vs 22 +/- 20 pg/ml (P < 0.01) for IL-8; and 2477 +/- 1642 mg/ l vs 1397 +/- 774 mg/l (P < 0.01) for GEL. The IL-6 levels returned to the preoperative values in both groups on POD 1; however, the GEL levels remained significantly higher in group B than in group A postoperatively, at 616 +/- 326 mg/l vs 378 +/- 70 mg/l on POD 1, and at 292 +/- 70 mg/l vs 218 +/- 62 mg/ l on POD 3 (P < 0.05). Thus high levels of cytokines such as IL-6, IL-8, and GEL may be detrimental to respiratory function.

Management and postoperative outcome in primary lung cancer and heart disease co-morbidity: a systematic review and meta-analysis

“…As for the systematic side effects attributed to the ECC, these have been extensively reported in literature (132)(133)(134)(135)(136)(137)(138)(139)(140). Immunologic disturbances induced by ECC, are considered to contribute to neoplastic disease spreading (101,141).…”

Gender-Specific Differences in Sex Hormones and Cytokines in Patients Undergoing Major Abdominal Surgery

“…Interleukin-8 is another proinflammatory cytokine that can be correlated with impaired organ function after surgery. 29 In addition to proinflammatory cytokines, anti-inflammatory cytokines are also produced in response to stressful events such as surgery. 30 We measured IL-10 as a representative anti-inflammatory cytokine, but found no gender-specific cytokine production for IL-6, IL-8, or IL-10.…”

Inhibition of lung permeability changes after burn and smoke inhalation by an anti-interleukin-8 antibody in sheep

“…Interleukin-8 (IL-8) has been proposed as a major chemotactic factor for the recruitment of neutrophils to extravascular sites of infl ammation. 6,7 Clinical studies have found rapidly increasing levels of circulating IL-8 in patients with large burns. 8 Moreover, the plasma concentration of IL-8 is correlated with the extent of burns and the presence of sepsis.…”