Effect of Ultrafiltration on Pulmonary Function and Interleukins in Patients Undergoing Cardiopulmonary Bypass

• Published in: Journal of cardiothoracic and vascular anesthesia Vol. 30; no. 4; pp. 884 - 890
• Main Authors: Kosour, Carolina, PhD, Dragosavac, Desanka, PhD, Antunes, Nilson, PhD, Almeida de Oliveira, Rosmari Aparecida Rosa, MSc, Martins Oliveira, Pedro Paulo, PhD, Wilson Vieira, Reinaldo, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2016
• Subjects: Aged; Anesthesia & Perioperative Care; Cardiopulmonary Bypass - adverse effects; Cardiopulmonary Bypass - methods; Coronary Artery Bypass - adverse effects; Coronary Artery Bypass - methods; coronary artery bypass grafts (CABG); Critical Care; Female; Hemofiltration - methods; Humans; Inflammation Mediators - metabolism; inflammatory mediators; interleukins; Interleukins - blood; lung; Lung - physiopathology; Lung Compliance - physiology; Male; Middle Aged; Oxygen - blood; Oxygen Consumption - physiology; Prospective Studies; Pulmonary Gas Exchange - physiology; Tumor Necrosis Factor-alpha - blood; ultrafiltration; inflammatory mediators; lung; coronary artery bypass grafts (CABG); ultrafiltration; interleukins
• ISSN: 1053-0770; 1532-8422
• DOI: 10.1053/j.jvca.2015.10.009

Objective To evaluate the effect of ultrafiltration on interleukins, TNF-α levels, and pulmonary function in patients undergoing coronary artery bypass grafting (CABG). Design Prospective, randomized, controlled trial. Setting University hospital. Participants Forty patients undergoing CABG were randomized into a group assigned to receive ultrafiltration (UF) during cardiopulmonary bypass (CPB) or into another group (control) that underwent the same procedure but without ultrafiltration. Methods Interleukins and TNF-α levels, pulmonary gas exchange, and ventilatory mechanics were measured in the preoperative, intraoperative, and postoperative periods. Interleukins and TNF-α also were analyzed in the perfusate of the test group. Measurements and Main Results There were increases in IL-6 and IL-8 at 30 minutes after CPB and 6, 12, 24, and 36 hours after surgery, along with an increase in TNF-α at 30 minutes after CPB and 24, 36, and 48 hours after surgery in both groups. IL-1 increased at 30 minutes after CPB and 12 hours after surgery, while IL-6 increased 24 and 36 hours after surgery in the UF group. The analysis of the ultrafiltrate showed the presence of TNF-α and traces of IL-1β, IL-6, and IL-8. There were alterations in the oxygen index, alveolar-arterial oxygen difference, deadspace, pulmonary static compliance and airway resistance after anesthesia and sternotomy, as well as in airway resistance at 6 hours after surgery in both groups, with no difference between them. Conclusions Ultrafiltration increased the serum level of IL-1 and IL-6, while it did not interfere with gas exchange and pulmonary mechanics in CABG.