Doenças Cardiovasculares e Diagnóstico

Effect of On-Pump CABG (Roller Versus Centrifugal Systems) on MCP-1, TNFsR and IL6 Behaviour

Abstract

Renato Braulio, Marcelo Dias Sanches, Antonio Lucio Teixeira Junior, Mauro Martins Teixeira, Paulo Henrique Nogueira Costa, Antonio Luiz Pinho Ribeiro, Claudia Alves Couto and Claudio Léo Gelape

Background We aimed to evaluate the cytokines monocyte chemotactic protein 1 (MCP-1), TNF soluble receptor (TNF-sR1) and interleukin 6 (IL-6) behavior in patients submitted to CABG (coronary artery bypass grafting) surgeries comparing roller to centrifugal extracorporeal circulation (ECC) pumping systems. Methods We randomized prospectively 43 adults who had elective on-pump CABG with the use of a roller (group I; n = 22) or a centrifugal system (group II; n = 21). Plasma levels of MCP-1, TNF-sR1 and IL-6 were determined by Elisa before the induction of anaesthesia (T1), 35 min after initiation of ECC (T2), 1 min after aortic declamping (T3), and 2, 6 and 24 h after the operation (T4, T5 and T6, respectively). The two groups were matched according to preoperative features. The groups I and II showed similar perioperative characteristics and clinical postoperative outcomes. The plasma levels of MCP-1 and TNF-sR1 reached a peak at T4 and T5 in both groups. MCP-1 in group I was significantly higher (P = 0.020) than in group II at T5, while plasma levels of TNF-sR1 in group I were significantly (P = 0.028) higher than in group II at T4. In both groups, the levels of IL-6 reached a peak at T5. Group I showed higher IL-6 plasma levels (P = 0.006). Conclusion We conclude that both roller and centrifugal pumps induce inflammatory responses to on-pump CABG procedures but higher levels of MCP-1, TNF-sR and IL6 were verified using roller systems.