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Thorac Cardiovasc Surg 2014; 62(08): 677-682
DOI: 10.1055/s-0034-1387824
Original Cardiovascular
Georg Thieme Verlag KG Stuttgart · New York

Low Tidal Volume Ventilation during Cardiopulmonary Bypass Reduces Postoperative Chemokine Serum Concentrations

Lucian Beer
1   Department of Thoracic Surgery, Medical University Vienna, Vienna, Austria
2   Christian Doppler Laboratory for Cardiac and Thoracic Diagnosis and Regeneration, Vienna, Austria
*   These authors contributed equally to this work.
,
Tamás Szerafin
3   Department of Cardiac Surgery, Institute of Cardiology, Medical and Health Science Centre of University of Debrecen, Hungary
*   These authors contributed equally to this work.
,
Andreas Mitterbauer
1   Department of Thoracic Surgery, Medical University Vienna, Vienna, Austria
2   Christian Doppler Laboratory for Cardiac and Thoracic Diagnosis and Regeneration, Vienna, Austria
,
Tamás Debreceni
3   Department of Cardiac Surgery, Institute of Cardiology, Medical and Health Science Centre of University of Debrecen, Hungary
,
Tamás Maros
3   Department of Cardiac Surgery, Institute of Cardiology, Medical and Health Science Centre of University of Debrecen, Hungary
,
Martin Dworschak
4   Department of Anesthesiology, General Intensive Care and Pain Medicine, Medical University of Vienna, Vienna, Austria
,
Georg A. Roth
4   Department of Anesthesiology, General Intensive Care and Pain Medicine, Medical University of Vienna, Vienna, Austria
,
Hendrik Jan Ankersmit
1   Department of Thoracic Surgery, Medical University Vienna, Vienna, Austria
2   Christian Doppler Laboratory for Cardiac and Thoracic Diagnosis and Regeneration, Vienna, Austria
› Author Affiliations
Further Information

Publication History

21 April 2014

23 June 2014

Publication Date:
10 September 2014 (online)

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Abstract

Background Open-heart surgery with cardiopulmonary bypass (CPB) is associated with a generalized immune response and postoperative lung dysfunction. Chemokines are involved in the pathogenesis of postoperative lung dysfunction. We investigated whether continued mechanical ventilation during CPB has an impact on chemokine serum concentrations.

Methods A total of 30 patients undergoing coronary artery bypass graft operation were randomized to either continuous ventilated group (n = 15) or nonventilated group (n = 15). Blood samples were drawn at the beginning and at the end of surgery and on the 5 consecutive days. Serum CCL2, CCL4, and CCL20 concentrations were measured and given as mean ± standard deviation.

Results Chemokine concentrations were elevated at the end of surgery in both groups. CCL2 and CCL4 levels returned to baseline on postoperative day (POD)-1 in the ventilation group and stayed elevated in the nonventilation group. CCL4 serum levels were significantly lower in ventilated-group patients on POD-1 (10.9 [39.0] vs. 153.2 [168.1]; p = 0.005), POD-2 (16.8 [36.8] vs. 147.9 [165.4]; p = 0.019), POD-3 (14.2 [24.0] vs. 97.9 [87.1]; p = 0.005), and POD-5 (6.5 [25.0] vs. 33.6 [38.4]; p = 0.045).

Conclusion Continued mechanical ventilation during CPB results in reduced CCL4 concentrations on POD-1 to -5.

Keywords

cardiopulmonary bypass - CCL2 - CCL4 - CCL20 - systemic inflammatory response syndrome - ventilation
 

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