2016 Volume 43 Issue 1 Pages 13-18
Objective:In a cardiopulmonary bypass(CPB) procedure, a systemic inflammatory response is activated by contact of blood with an extracorporeal circuit during re-transfusion of pericardial suction blood(PSB). The aim of this study was to clarify activation of specific cytokines and the efficacy of PSB washing to attenuate inflammatory reactions during CPB.Methods:Blood samples were collected from 20 patients undergoing elective open-heart surgery using CPB at the time of aortic de-clamping. PSB was washed using an autologous blood recovery device(HVR-DUAL, Sorin Inc), then CBC, serum chemistry, Free-Hb, and IL-6 values were measured in circulating blood(V-group), PSB(K-group), and washed blood(S-group).Results: The value for serum IL-6 was 7.78 times higher in the K-group than the V-group (467±460 vs. 68±56 pg/mL, P< 0.01), while that was significantly decreased by the washing procedure(K-group vs. S-group: 467±460 vs. 51±60 pg/mL; P<0.01). In addition, the serum free Hb value was 3.69 times higher in the K-group than the V-group (0.21±0.12 vs. 0.06±0.04 g/dL;P<0.01) and was also significantly reduced by washing (K-group vs. S-group: 0.21±0.12 vs. 0.03±0.02 g/dL; P<0.01). Platelet count and Free-Hb were significant factors for increased serum IL-6 in PSB, and PSB washing resulted in a 68±16% reduction in platelet count.Conclusion: Serum IL-6 was markedly increased in PSB during CPB. PSB washing may be useful to attenuate cytokine activation caused by CPB.
