Evaluation of Systemic Inflammatory Response in Cardiovascular Surgery via Interleukin-6, Interleukin-8, and Neopterin

2014 ◽  
Vol 17 (1) ◽  
pp. 13 ◽  
Author(s):  
Ihsan Sami Uyar ◽  
Suleyman Onal ◽  
Ayhan Uysal ◽  
Ugur Ozdemir ◽  
Oktay Burma ◽  
...  
Keyword(s):  
Inflammatory Response ◽  
Valve Replacement ◽  
Interleukin 6 ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Beating Heart ◽  
Systemic Inflammatory Response ◽  
The Other ◽  
Open Heart ◽  
Group 3

<p><b>Aim:</b> The aim of this study was to evaluate the serum levels of interleukin-6 (IL-6), IL-8, and neopterin as a sign of systemic inflammatory response syndrome after open-heart surgery. In this study, we evaluated the influences on the levels of IL-6, IL-8, and neopterin of coronary artery bypass grafting (CABG) and valve replacement surgeries with and without the use of extracorporeal circulation (ECC).</p><p><b>Materials and Methods:</b> This prospective study was performed in 30 patients. In this study, we evaluated patients who underwent valve replacement surgery (group 1, n = 10), CABG with ECC (group 2, n = 10), or CABG using the beating-heart technique (group 3, n = 10). With the Human Investigation Ethics Committee consent, blood samples were obtained from the patients before the surgery (T0) and after 1 hour (T1), 4 hours (T2), 24 hours (T3), and 48 hours (T4) of protamine injection. IL-6, IL-8, and neopterin levels were measured using commercial enzyme-linked immunosorbent assay kits.</p><p><b>Results:</b> The demographic data and preoperative and operative characteristics of the patients were similar. Neopterin IL-6 and IL-8 levels significantly increased first at the fourth hour after the surgery. When compared to the levels before the surgery, this increase was statistically significant. Unlike the other 2 groups of patients, those who experienced CABG with the beating-heart technique (group 3) had decreased neopterin levels at the first hour after the surgery, but this decrease was not statistically significant. Neopterin levels increased later in the OPCAB group, but these increased levels were not as high as the neopterin levels of groups 1 and 2. Neopterin reached maximum levels at the 24th hour and, unlike groups 1 and 2, in group started to decrease at the 48th.</p><p><b>Conclusions:</b> Complement activation, cytokine production, and related cellular responses are important factors during open-heart surgery. It is certain that ECC activates the complement systems, and activated complement proteins cause the production of several cytokines. In our study, neopterin levels in patients who underwent beating-heart method surgery were lower than those in the other groups, and these levels started to decrease at the 48th hour. These data suggest that the systemic inflammatory response was less activated in that patient group. The beating-heart method might be an important alternative in CABG surgery to minimize the complications and mortality related to surgery.</p>

scholarly journals The Effects of Norepinephrine Infusion on the Circulating Lymphocyte Counts of Post–Open Heart Surgery Patients

2000 ◽  
Vol 1 (3) ◽  
pp. 199-209
Author(s):  
Wanda Zziwambazza ◽  
Carrie J. Merkle ◽  
Ida M. Moore ◽  
Jean Davis
Keyword(s):  
Heart Surgery ◽  
Open Heart Surgery ◽  
The Other ◽  
Open Heart ◽  
Postoperative Infections ◽  
Norepinephrine Infusion ◽  
Beta Blocking ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

In this retrospective study employing chart reviews, 75 open heart surgery patients (OHSPs) were divided into 3 groups of 25 patients. Group 1 received no intravenous (IV) norepinephrine (NE) after surgery. Group 2 and group 3 received a minimum of 0.028 mcg/kg/min of IV NE for 6-24 h and greater than 24 h, respectively. In the 3 groups, preoperative lymphocyte counts were compared to counts obtained on postoperative days 1 and 2. The results showed lower lymphocyte counts on postoperative day 2 in group 3 subjects, who received NE for 24 h or more, compared to subjects of the other groups who received no NE or 6-24 h of NE (p < 0.05). There was also evidence that preoperative use of beta-blocking agents significantly affected the change in lymphocyte counts from day 1 to day 2 in both groups receiving NE. Furthermore, postoperative infections were more prevalent in group 3 than the other 2 groups (p < 0.05). The lower lymphocyte counts and higher infection rate, however, may be linked to lower postoperative blood pressure and increased number of intensive care unit days in group 3. Further investigation is warranted to elucidate the effects of IV NE administration on the lymphocyte counts of OHSPs and to reduce infections in those receiving NE.

Procalcitonin kinetics in pediatric patients with systemic inflammatory response after open heart surgery

2006 ◽  
Vol 32 (6) ◽  
pp. 881-887 ◽  
Author(s):  
Serdar Celebi ◽  
Ozge Koner ◽  
Ferdi Menda ◽  
Huriye Balci ◽  
Alican Hatemi ◽  
...  
Keyword(s):  
Inflammatory Response ◽  
Heart Surgery ◽  
Pediatric Patients ◽  
Open Heart Surgery ◽  
Systemic Inflammatory Response ◽  
Open Heart

The value of procalcitonin in systemic inflammatory response syndrome after open-heart surgery for CHD

2019 ◽  
Vol 29 (11) ◽  
pp. 1335-1339
Author(s):  
Kuntum Basitha ◽  
Rubiana Sukardi ◽  
Ratna Farida Soenarto ◽  
Suprayitno Wardoyo
Keyword(s):  
Platelet Count ◽  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Systemic Inflammatory Response ◽  
Open Heart ◽  
Time Duration ◽  
Procalcitonin Level ◽  
Significant Difference

AbstractBakground:Systemic inflammatory response syndrome, which is marked by fever, is a possible complication after open-heart surgery for CHD. The inflammatory response following the use of cardiopulmonary bypass shows similar clinical signs with sepsis. Therefore serial measurements of procalcitonin, an early infection marker, can be helpful to differentiate between sepsis and systemic inflammatory response syndrome.Objectives:To evaluate serial levels of procalcitonin in children who underwent open-heart surgery for cyanotic and acyanotic CHD, and identify factors associated with elevated level of procalcitonin.Methods:Children and infants who had open-heart surgery and showed fever within 6 hours after surgery were recruited. Procalcitonin levels were serially measured along with leukocyte and platelet count. Other data were also recorded, including diagnosis, age, body weight, axillary temperature, aortic clamp time, bypass time, duration of mechanical ventilation, risk adjustment for congenital heart surgery score-1, and length of stay in Cardiac ICU. The patients were categorised into cyanotic and acyanotic CHD groups.Results:High mean of procalcitonin level suggested the presence of bacterial infection. Cyanotic CHD group had significantly higher mean of procalcitonin level compared to acyanotic CHD group in the first two measurements. Both groups had no leukocytosis, though platelet count results were significantly different between the two groups. There was no significant difference of procalcitonin level observed in culture results and adverse outcomes.Conclusion:Serial procalcitonin measurement can be helpful to determine the cause of fever. Meanwhile other conventional markers such as leukocyte and platelet should be assessed thoroughly.

scholarly journals P1655Preoperative predictors for systemic inflammatory response in open-heart surgery

2018 ◽  
Vol 39 (suppl_1) ◽  
Author(s):  
E Viikinkoski ◽  
M Hollmen ◽  
J Jalkanen ◽  
J Gunn ◽  
J Airaksinen ◽  
...  
Keyword(s):  
Inflammatory Response ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Systemic Inflammatory Response ◽  
Open Heart

Depression and anxiety following open heart surgery: Mediation of coping, spiritual struggle and interleukin-6

2011 ◽  
Vol 26 (S2) ◽  
pp. 597-597
Author(s):  
A. Ai ◽  
H. Appel ◽  
Z. Kronfol
Keyword(s):  
Mental Health ◽  
Interleukin 6 ◽  
Indirect Effects ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Well Being ◽  
Mediating Effect ◽  
Open Heart ◽  
Spiritual Struggle ◽  
Maladaptive Coping

IntroductionFactors pertaining to religion and spirituality have been linked with well-being and adequate coping. Few studies have investigated negative aspects of religious coping, such as spiritual struggle.ObjectivesBased on multidisciplinary literature and previous findings, our study's objectives are to estimate the parallel psychophysiological pathways from pre-operative distress to post-operative depression in patients undergoing open heart surgery.AimsThe study's aims are to examine the association in depression, anxiety, and how coping, spiritual struggle and interleukin-6 play a role in patients following open heart surgery.MethodsPlasma samples for interleukin-6 (IL-6) were obtained before open heart surgery. Patients’ history and demographic information obtained through interviews 2 days before surgery. Follow up interview for mental health and religious were conducted before and after surgery.ResultsThe results showed that a link between spiritual struggle and IL-6 mediated the indirect effects of pre-operative anxiety on post-operative depression. Anxiety had positive indirect effects on post-operative hostility. Further, hope played a protective mediating role to moderate the undesirable influences of the spiritual struggle-IL-6 link and maladaptive coping on post-operative mental health attributes.ConclusionsOur study estimated important psychophysiological pathways from pre-operative distress to post-operative maladjustment. To our knowledge, this model is the first analysis to demonstrate the significant mediating effect of the spiritual-IL-6 link, alongside that of positive religious copping and other maladaptive coping, in this population.

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