Producción CientíficaBackground: Systemic inflammatory response frequently
occurs after coronary artery bypass surgery and is strongly
correlated with the risk of postoperative morbidity and
mortality. This study tests the hypothesis that the priming
of the extracorporeal circuit with colloid solutions results
in less inflammation in patients undergoing cardiac surgery
than priming with crystalloid solutions.
Methods: A prospective, randomized studywas designed.
Forty-four patients undergoing elective coronary artery
bypass grafting were randomly allocated to one of two
groups: 22 patients primed with Ringer’s lactate (RL)
solution and 22 patients primed with gelatin-containing
solution during the surgery. Plasma levels of interleukin
(IL)-6, IL-8, tumor necrosis factor (TNF)-a, C-reactive
protein (CRP) and, complement 4 were measured during
the surgical intervention and over the following 48
postoperative hours. Cytokine levels were measured by
enzyme-linked assays from plasma samples obtained at
specific time points pre- and post-operatively.
Results: In both groups the serum levels of the pro-inflammatory
cytokines (IL-6, IL-8, TNF-a), CRP, complement 4, and
leukocytes increased significantly over the baseline, although no
significant differences were observed between the two groups.
The operation time, blood loss, need for inotropic support,
extubation time, and length of intensive care unit stay did not
differ significantly between the two groups.
Conclusion: Priming with gelatin vs. RL produces no
significant differences in the inflammatory response in
patients undergoing coronary artery bypass grafting with
cardiopulmonary bypass
