Release of Cardiac Biochemical and Inflammatory Markers in Patients on Cardiopulmonary Bypass Undergoing Coronary Artery Bypass Grafting

Abstract

Monitoring of these markers could help to determine implementation of protective interventions during CABG with CPB to prevent myocardial deterioration and to predict the risk and prognosis.

Safety and Effectiveness of two treatment regimes with tranexamic acid to minimize inflammatory response in elective cardiopulmonary bypass patients: a randomized double-blind, dose-dependent, phase IV clinical trial

“…Peak levels of this interleukin is observed in these first hours of the postoperative period, as found by our team in a previous study [6] and by others [16,17]. The presence of hyperthermia in the criteria used avoids the potential confounding effect of vasoactive drugs on the associated hyperdynamic state.…”

“…In addition to the feed-back between the release of inflammatory markers and fibrinolysis, other components must be considered in the release of these markers. After CPB (Figure 2) we observed a clear increase in the levels of IL-6 and other interleukins, which interact with each other [16,17] and are involved in producing fever ("postperfusion syndrome") [22]. Also, oxidative stress induced by norepinephrine may release IL-6 in other settings [23].…”

Metformin is not associated with lactic acidosis in patients with diabetes undergoing coronary artery bypass graft surgery: a case control study

“…The average lactate was initially 0.83 ± 0.28 mmol/l on induction for surgery, 0.87 ± 0.33 a half hour from induction, 2.84 ± 1.68 after a quarter of an hour on cardio-pulmonary bypass, 3.48 ± 2.23 at the end of cardio-pulmonary bypass, 4.28 ± 2.48 at the end of surgery, and 4.33 ± 2.56 during ICU admission. A similar study by Meng et al [22] measured lactate and other inflammatory markers in patients undergoing on-pump CABG every 6 h for 24 h after the start of cardio-pulmonary bypass. The lactate was recorded as follows: T0 (1.12 ± 1 mmol/l), T1 (1.15 ± 0.07), T2 (3.12 ± 0.21), T3 (2.97 ± 0.18), T4 (2.58 ± 0.25).…”

“…This is further aggravated by the post-operative increased oxygen demand, low output cardiac state, and use of vasoactive agents. This cascade of events can inflect visceral organ injury manifesting in a recognized pattern of liver, kidney, and pancreas biomarker surge within the first 2–3 days after surgery [20–22]. …”

Untitled

“…Plasma interleukin (IL)-6 may play an important role in the development of SIRS [8]. Research has found that IL-6 level are significantly elevated one hour after initiation of CPB and peaks at six hours [9]. Surgical trauma, abnormal shear stress, ischemia, reperfusion, and hypothermia can activate the secretion of IL-6, which can remain elevated after surgery [10][11][12][13][14][15][16].…”