Pulmonary function and inflammatory markers in patients undergoing coronary revascularisation with or without cardiopulmonary bypass.

Abstract

Lung injury after cardiac surgery is believed to result from cardiopulmonary bypass and its pro-inflammatory effects. To test this hypothesis, we compared the oxygenation ratios, extravascular lung water indices and systemic and pulmonary tumour necrosis factor alpha (TNF-alpha) and interleukin (IL)-8 at predetermined intervals in coronary artery surgery patients with or without cardiopulmonary bypass. No differences in oxygenation ratios or extravascular lung water indices were found. Serum values of TNF-alpha and IL-8 increased in both groups but were higher in the cardiopulmonary bypass group (end of surgery: mean (SD) TNF-alpha 3.68 (2.5) vs 2.20 (1.2) pg.ml(-1) (p = 0.043 (CI 0.05-2.9)) and mean (SD) IL-8 19.45 (10.8) vs 6.31 (5.3) pg.ml(-1) (p = 0.001 (CI 6.9-19.3)). In broncho-alveolar lavage fluid, TNF-alpha and IL-8 increased in both groups with no differences between the groups.