Version 1
: Received: 3 June 2023 / Approved: 6 June 2023 / Online: 6 June 2023 (02:27:43 CEST)
How to cite:
Milic, D.; Lazarević, M.; Lazarevic, Z.; Golubovic, M.; Peric, V.; Marjanovic, P.; Marjanovic, V.; Zivic, S.; Milic, I.; Kamenov, A.; Stojilkovic, V. Systemic Cytokine Response During the Extracorporeal Circulation in Patients with Myocardial Revascularization. Preprints2023, 2023060358. https://doi.org/10.20944/preprints202306.0358.v1
Milic, D.; Lazarević, M.; Lazarevic, Z.; Golubovic, M.; Peric, V.; Marjanovic, P.; Marjanovic, V.; Zivic, S.; Milic, I.; Kamenov, A.; Stojilkovic, V. Systemic Cytokine Response During the Extracorporeal Circulation in Patients with Myocardial Revascularization. Preprints 2023, 2023060358. https://doi.org/10.20944/preprints202306.0358.v1
Milic, D.; Lazarević, M.; Lazarevic, Z.; Golubovic, M.; Peric, V.; Marjanovic, P.; Marjanovic, V.; Zivic, S.; Milic, I.; Kamenov, A.; Stojilkovic, V. Systemic Cytokine Response During the Extracorporeal Circulation in Patients with Myocardial Revascularization. Preprints2023, 2023060358. https://doi.org/10.20944/preprints202306.0358.v1
APA Style
Milic, D., Lazarević, M., Lazarevic, Z., Golubovic, M., Peric, V., Marjanovic, P., Marjanovic, V., Zivic, S., Milic, I., Kamenov, A., & Stojilkovic, V. (2023). Systemic Cytokine Response During the Extracorporeal Circulation in Patients with Myocardial Revascularization. Preprints. https://doi.org/10.20944/preprints202306.0358.v1
Chicago/Turabian Style
Milic, D., Aleksandar Kamenov and Vladimir Stojilkovic. 2023 "Systemic Cytokine Response During the Extracorporeal Circulation in Patients with Myocardial Revascularization" Preprints. https://doi.org/10.20944/preprints202306.0358.v1
Abstract
Revascularization of the myocardium under conditions of extracorporeal circulation cause clinical problems related to the effects of the intervention itself on the immune system and inflammatory response, especially systemic inflammatory response (Engl. Systemic Inflammatory Response Syndrome, SIRS).
This prospective study included 100 patients who underwent single, double and triple surgical revascularization of the myocardium, at the Clinic for Cardiac Surgery of CC Niš, in the period from January 15., 2020. until January 15., 2021. 22 female persons - 22.0% and 78 male persons - 78.0%) were included. Preoperatively, as well as 8 hours after the surgical intervention, the following parameters were determined for the subjects: blood count (erythrocyte count - Rbc, hemoglobin - Hgb, hematocrit - Hct, leukocyte count - Wbc, platelet count - Plt) and CRP, soluble CD14 molecule (sCD 14) - presepsin, levels of the following cytokines: TNFα, IL-1β, IL-2, IL-4, IL-6, IL-10, IL-12 p70 and IFN γ.
Patients in whom the extracorporeal circulation method was applied had, postoperatively, a higher concentration of CRP (p<0.001), as well as a concentration of presepsin (p<0.05) - a greater number of patients had a concentration of presepsin above the limit of 600 pg/ mL (p<0.01). Four patients out of 51 (7.84%) in the ECB group had elevated presepsin values over 1000 pg/ml and high risk according to clinical criteria for the development of systemic bacterial infection and sepsis. No such patients were recorded in the off pump group. Also, in the group where the extracorporeal blood flow system was applied, 17.64% of patients (9/51) met the clinical criteria for SIRS with elevated presepsin values over 600 pg/mL, while in the other group of patients, 2 out of 49 (4.08%) met the clinical criteria and laboratory criteria for SIRS. Except for TNFa, the levels of IL-1β, IL-2, IL-6 and IL-10 showed an increase after the intervention in all groups compared to the preoperative period (p<0.01).
However, comparing the degree of cytokine increase in the postoperative period between the control (off pump) and the extracorporeal blood flow group did not show a statistical difference (IL-2; p=0.881, IL-1; p=0.709, IL-6; p=0.911, IL- 10, p=0.179).
In the postoperative period, a higher incidence rate of SIRS was noted in patients in whom the ECB system was used, which also indicates its importance in the development of systemic inflammation and immune dysregulation.
Medicine and Pharmacology, Cardiac and Cardiovascular Systems
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
