题名

Inflammatory Response to Colloids Compared to Crystalloid Priming in Cardiac Surgery Patients with Cardiopulmonary Bypass

DOI

10.4077/CJP.2012.BAA028

作者

Huey-Ling Liou;Chun-Che Shih;Yann-Fen C. Chao;Nien-Tsung Lin;Shau-Ting Lai;Shu-Hua Wang;Hsing I Chen

关键词

cardiac surgery ; cardiopulmonary bypass ; priming solutions ; inflammatory response

期刊名称

The Chinese Journal of Physiology

卷期/出版年月

55卷3期(2012 / 06 / 01)

页次

210 - 218

内容语文

英文

英文摘要

Cardiac surgery with cardiopulmonary bypass (CPB) induces a systemic inflammatory response syndrome that may contribute to postoperative morbidity and mortality. We investigated the inflammatory responses to colloids compared to crystalloid priming in cardiac surgery patients with cardiopulmonary bypass. Thirty patients undergoing coronary artery bypass grafting (CABG) preparing for CPB were randomized into Ringer's solution (RS), 10% hydroxyethyl starch (HES) or 25% human albumin (HA) group. Serum concentrations of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), interleukin-6 (IL-6) and interleukin-10 (IL-10) were measured before CPB, at the end of CPB and 1, 6 and 12 h after CPB. Serum C-reactive protein (CRP) was determined pre-operatively and then daily for 2 days. Body-weight gain was significantly decreased on the day after surgery in the HES group than in the RS group. Volume priming in CPB for CABG patients using HA or HES preparation had less tendency for intense inflammatory response with lower levels of TNF-α, IL-1β, IL-6 and higher levels of IL-10 compared to patients treated with RS. HES prime had lower levels of circulating CRP than in patients treated with HA or Ringer prime on the second post-operative day. Our data indicate that volume priming using colloid during CPB in CABG patients might exert beneficial effects on inflammatory responses.

主题分类 醫藥衛生 > 基礎醫學
参考文献
  1. Aukerman, J.,Voepel-Lewis, T.,Riegger, L. Q.,Siewert, M.,Shayevitz, J. R.,Mosca, R.(1998).The relationship between extracorporeal circuit prime, albumin, and postoperative weight gain in children.J. Thorac. Cardiovasc. Surg.,12,408-414.
  2. Barron, M. E.,Wilkes, M. M.,Navickis, R. J.(2004).A systematic review of the comparative safety of colloids.Arch. Sur.,139,552-563.
  3. Baumann, H.,Richards, C.,Gauldie, J.(1987).Interaction among hepatocyte-stimulating factors, interleukin-1, and glucocorticoids for regulation of acute phase plasma proteins in human hepatoma (Hep G2) cells.J. Immunol.,139,4122-4128.
  4. Biffl, W. L.,Moore, E. E.,Moore, F. A.,Barnett, C.C., Jr.(1996).Interleukin-6 delays neutrophil apoptosis via a mechanism involving platelet-activating factor.J. Trauma,40,575-578.
  5. Boldt, J.,Ducke, M.,Kumle, B.,Papsdorf, M.,Zurmeye, E. L.(2004).Influence of different volume replacement strategies on inflammation and endothelial activation in the elderly undergoing major abdominal surgery.Intens. Care Med.,30,416-422.
  6. Boldt, J.,Suttner, S.,Brosch, C.,Lehmann, A.,Röhm, K.,Mengistu, A(2009).Cardiopulmonary bypass priming using a high dose of a balanced hydroxyethyl starch versus an albumin-based priming strategy.Anesth. Analg.,109,1752-1762.
  7. Butler, J.,Pathi, V. L.,Paton, R. D.,Logan, R. W.,MacArthur, K.,Jamieson, M. P.,Pollock, J. C.(1996).Acute-phase responses to cardiopulmonary bypass in children weighing less than 10 kilograms.Ann. Thorac. Surg.,62,538-542.
  8. Dokka, S.,Shi, X.,Leonard, S.,Wang, L.,Castranova, V.,Rojanasakul, Y.(2001).Interleukin-10-mediated inhibition of free radical generation in macrophages.Am. J. Physiol. Lung Cell Mol. Physiol.,280,1196-1202.
  9. Elhabbal, M. H.,Smith, L. J.,Elliot, M. J.,Strobel, S.(1997).Cardiopulmonary bypass tubes and prime solutions stimulate neutrophil adhesion molecules.Cardiovasc. Res.,33,209-215.
  10. Emmerson, T. E.(1989).Unique features of albumin. A brief review.Crit. Care Med.,17,690-693.
  11. Hall, R.,Smith, M.,Rocker, G.(1997).The systemic inflammatory response to cardiopulmonary bypass: pathophysiological, therapeutic, and pharmacological considerations.Anesth. Analg.,85,766-882.
  12. Heeschen, C.,Dimmeler, S.,Hamm, C. W.,Fichtlscherer, S.,Boersma, E.,Simoons, M. L.,Zeiher, A. M.(2003).Serum level of antiinflammatory cytokine interleukin-10 is an important prognostic determinant in patients with acute coronary syndromes.Circulation,107,2109-2114.
  13. Liebold, A.,Keylb, C.,Birnbauma, D. E.(1999).The heart produces but the lungs consume proinflammatory cytokines following cardiopulmonary bypass.Eur. J. Cardiothorac. Surg.,15,340-345.
  14. Mackiewicz, A.,Speroff, T.,Ganapathi, M. K.,Kushner, I.(1991).Effects of cytokine combinations on acute phase protein production in two human hepatoma cell lines.J. Immunol.,146,3032-3037.
  15. Paparella, D.,Yau, T. M.,Young, E.(2002).Cardiopulmonary bypass induced inflammation: pathophysiology and treatment. An update.Eur. J. Cardiothorac. Surg.,21,232-244.
  16. Pepys, M. B.,Hirschfield, G. M.,Tennent, G. A.,Gallimore, J. R.,Kahan, M. C.,Bellotti, V.,Hawkins, P. N.,Myers, R. M.,Smith, M. D.,Polara, A.,Cobb, A. J.,Ley, S. V.,Aquilina, J. A.,Robinson, C. V.,Sharif, I.,Gray, G. A.,Sabin, C. A.,Jenvey, M. C.,Kolstoe, S. E.,Thompson, D.,Wood, S. P.(2006).Targeting C-reactive protein for the treatment of cardiovascular disease.Nature,440,1217-1221.
  17. Prasad, K.(2003).C-reactive protein and cardiovascular diseases.Int. J. Angiol.,12,1-12.
  18. Remick, D. G.,Bolgos, G. R.,Siddiqui, J.,Shin, J.,Nemzek, J. A.(2002).Six at six: interleukin-6 measured 6 hours after the initiation of sepsis predicts mortality over 3 days.Shock,17,463-467.
  19. Russell, J. A.,Navickis, R. J.,Wilkes, M. M.(2004).Albumin versus crystalloid for pump priming in cardiac surgery: Meta-analysis of controlled trials.J. Thorac. Cardiovasc. Surg.,18,429-437.
  20. Sade, R. M.,Stroud, M. R.,Crawford, F. A., Jr,Kratz, J. M.,Dearing, J. P.,Bartles, D. M.(1985).A prospective randomized study of hydroxyethyl starch, albumin, and lactated Ringer's solution as priming fluid for cardiopulmonary bypass.J. Thorac. Cardiovasc. Surg.,89,713-722.
  21. Schneider, S. O.,Rensing, H.,Gräber, S.,Kreuer, S.,Kleinschmidt, S.,Kreimeier, S.,Müller, P.,Mathes, A. M.,Biedler, A. E.(2009).Impact of platelets and fresh frozen plasma in contrast to red cell concentrate on unstimulated and stimulated cytokine release in an in vitro model of transfusion.Scand. J. Immunol.,70,101-105.
  22. Singh, U.,Devaraj, S.,Dasu, M. R.,Ciobanu, D.,Reusch, J.,Jialal, I.(2006).C-Reactive protein decreases interleukin-10 secretion in activated human monocyte-derived macrophages via inhibition of cyclic AMP production.Arterioscler. Thromb. Vasc. Biol.,26,2469-2475.
  23. Singh, U.,Devaraj, S.,Jialal, I.(2005).CRP decreases tPA activity in HAECs: evidence that CRP is a procoagulant.Arterioscler. Thromb. Vasc. Biol.,25,2216-2221.
  24. Steinberg, J. B.,Kapelanski, D. P.,Olson, J. D.,Weiler, J. M.(1993).Cytokine and complement levels in patients undergoing cardiopulmonary bypass.J. Thorac. Cardiovasc. Surg.,106,1008-1016.
  25. Tamayo, E.,Álvarez, F. J.,Castrodeza, J.,Bustamante, R.,Gómez-Herreras, J. I.,Florez, S.,Rodriguez, R.(2008).The inflammatory response to colloids and crystalloids used for pump priming during cardiopulmonary bypass.Acta. Anaesthesiol. Scand.,52,1204-1212.
  26. Teoh, K. H.,Bradley, C. A.,Gauldie, J.,Burrows, H.(1995).Steroid inhibition of cytokine-mediated vasodilation after warm heart surgery.Circulation,92,347-353.
  27. Tian, J.,Lin, X.,Guan, R.,Xu, J. G.(2004).The effects of hydroxyethyl starch on lung capillary permeability in endotoxic rats and possible mechanisms.Anesth. Analg.,98,768-774.
  28. Varga, R.,Török, L.,Szabó, A.,Kovács, F.,Keresztes, M.,Varga, G.,Kaszaki, J.,Boros, M.(2008).Effects of colloid solutions on ischemia reperfusion-induced periosteal microcirculatory and inflammatory reactions: comparison of dextran, gelatin, and hydroxyethyl starch.Crit. Care Med.,36,2828-2837.
  29. Verma, S.,Devaraj, S.,Jialal, I.(2006).Is CRP an innocent bystander or proatherogenic culprit? CRP promotes atherothrombosis.Circulation,113,2135-2150.
  30. Wan, S.,Izzat, M.,Lee, T. W.,Wan, I. Y.,Tang, N. L.,Yim, A. P.(1999).Avoiding cardiopulmonary bypass in multivessel-CABG reduces cytokine response and myocardial injury.Ann. Thorac. Surg.,68,52-57.
被引用次数
  1. Wan, Lei,Lin, Jane-Ming,Lin, Hui-Ju,Lin, Hsiu-Chu,Lin, Chih-Hung,Lee, Kuan-Rong,Huang, Su-Hua,Huang, Chi-Chun,Hsu, Yu-An,Chen, Ying-Chi,Chang, Ching-Yao(2016).Effect of microRNA-155 on the Interferon-Gamma Signaling Pathway in Biliary Atresia.中國生理學雜誌,59(6),315-322.