Original Article

Proinflammatory Mediator Response in Coronary Bypass Surgery Using a Centrifugal or a Roller Pump

Departments of Anaesthesiology, Surgery, Paediatrics, Clinical Chemistry and Pathology, and Medicity Research Laboratory, University of Turku, Turku, Finland

^* Address correspondence to: Matti Salo, MD, PhD, Department of Anaesthesiology, University of Turku, FIN-20520 Turku, Finland, Fax +358-21-2613960, Tel +358-21-2611969

Abstract

Major surgery, trauma, and infection induce a proinflammatory mediator response which, if excessive, may cause tissue injury. The response was measured during elective coronary bypass surgery when a centrifugal pump or a roller pump, differing in their basic working principles, was used for extracorporeal circulation (ECC). Eight patients were perfused with a centrifugal pump and eight patients with a roller pump during ECC. Plasma interleukin-1_β(IL-1_β), IL-2, IL-6, tumor necrosis factor_α (TNF_α), group II phospholipase A₂, (PLA₂), endotoxin, fibronectin and serum C-reactive protein (CRP) concentrations were measured. The operation increased plasma IL-6, group II PLA₂, and serum CRP concentration and decreased plasma fibronectin concentrations. IL-1_β and TNF_α concentrations did not change. IL-2 ocurred only occasionally, and endotoxin did not occur in any patient. No differences were seen between the group using a centrifugal pump and the group using the roller pump. Cardiac surgery with a perfusion time of less than two hours thus caused a proinflammatory mediator response which was similar whether a centrifugal or a roller pump was used for ECC.