Plasma Levels of Selectins and Interleukins in Cardiovascular Surgery Using Cardiopulmonary Bypass

Abstract

Background: Cardiovascular surgery with cardiopulmonary bypass (CPB) leads to activation of a variety of inflammatory pathways, including the release of cytokines and selectins. Methods: In 20 patients undergoing elective coronary artery bypass grafting, plasma levels of interleukins IL-2, -6, -8, -10, -12 and of P-, E-, and L-selectins were measured at eight time points before, during, and after CPB using a standardized ELISA technique. Results: IL-2 plasma levels decreased significantly after the start of CPB and remained low until the second postoperative day. IL-6 and IL-8 levels increased significantly after weaning off CPB, with mean peak values six hours postoperatively. Very low IL-10 plasma levels were detectable preoperatively. They remained low during CPB and peaked significantly after weaning off CPB until skin closure. The IL-12 levels decreased after weaning off CPB (p< 0.05) until 6 hours postoperatively. The plasma levels of P-selectin showed no alterations, but concentrations of E- and L-selectin decreased after the Start of CPB (p< 0.05). There were no adverse postoperative events. Conclusions: The results of our study demonstrate a dysregulation of cytokine and selectin production during and up to 48 h after CPB, which may be a “normal" stress reaction to CPB.

Key words

Cardiovascular surgery - Extracorporeal circulation - Interleukins - Selectins - Immunodysregulation