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

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-l β(IL-lβ), IL-2, IL-6, tumor necrosis factorα (TNF α), group II phospholipase A2, (PLA2), endotoxin, fibronectin and serum Creactive protein (CRP) concentrations were measured. The operation increased plasma IL-6, group II PLA2, and serum CRP concentration and decreased plasma fibronectin concentrations. IL-lβ and TNFα 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.