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Critical Care  2005 

On-pump versus off-pump coronary artery bypass grafting: relationship between complications and released cytokines after on-pump surgery

DOI: 10.1186/cc3560

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Abstract:

The goal of this study was to evaluate the relationship between inflammatory markers and biochemical evidence of myocardial cell injury in patients who underwent coronary bypass grafting (CABG) with (on-pump) or without (off-pump) extracorporeal circulation.All patients had myocardial infarction with multivessel coronary artery disease with preserved ventricular function and without renal failure or other cardiac diseases. The mean age was 46.6 ± 12.5 years. Cytokines were measured 6 and 24 hours postoperatively by ELISA and immunoassay, and were correlated to the occurrence of the following clinical complications: fever, atrial fibrillation, significant pericardial effusion, pulmonary complications, and release of CK-MB and troponin I.Of the 724 CABGs performed in a single-center tertiary hospital, 218 were off-pump and 506 were on-pump. The mean age was 46.6 ± 12.5 years and the mean time of extracorporeal circulation was 72 ± 23 min. Clinical complications were more frequent among on-pump patients (Table 1). This was associated with higher levels of C-reactive protein, CK-MB and troponin I, but not IL-6 (Table 2).Postoperative complications and biochemical evidence of myocardial cell damage after CABG were more frequent among on-pump patients, and this was correlated with higher serum levels of C-reactive protein.

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