Passaroni Andréia Cristina, Felicio Marcello Laneza, Campos Nelson Leonardo Kerdahi Leite de, Silva Marcos Augusto de Moraes, Yoshida Winston Bonida
Discipline of Cardiovascular Surgery, Department of Surgery and Orthopedics, Hospital das Clínicas da Faculdade de Medicina de Botucatu da Universidade Estadual Paulista (HCFMB-UNESP), Botucatu, SP, Brazil.
Braz J Cardiovasc Surg. 2018 Jan-Feb;33(1):64-71. doi: 10.21470/1678-9741-2017-0125.
To compare the perioperative incidence rates of hemolysis and inflammatory response in patients undergoing coronary artery bypass grafting with the two main types of cardiopulmonary bypass, centrifugal and roller pumps, and establish correlations among hemolytic and inflammatory changes.
This was a prospective, randomized trial of 60 patients assigned to either roller pump (G1, n=30) or centrifugal pump (G2, n=30) bypass. Markers of hemolysis (serum haptoglobin, lactate dehydrogenase [LDH]) and inflammation (interleukin [IL]1ß, IL-6, and TNF-α) were measured and analyzed.
There was no significant between-group difference in the variables of interest. In G1, there was a positive association with IL-6 and TNF-α (P<0.01 and P<0.05, respectively). In G2, there was a positive association with LDH in the postoperative period (P<0.5). At 24h post-cardiopulmonary bypass, there were positive associations between LDH and IL-1ß (P<0.05), LDH and TNF-α (P<0.01), haptoglobin and TNF-α (P<0.05), and LDH and TNF-α (P<0.01) in G1, and between LDH and IL-6 (P<0.01), LDH and TNF-α (P<0.01), and LDH and IL-6 (P<0.01) in G2.
There were no significant between-group differences in markers of hemolysis or inflammation. IL-6 and TNF-α were positively associated with duration of cardiopulmonary bypass in G1, while LDH was positively associated with duration of cardiopulmonary bypass in G2. The rate of significant associations between markers of hemolysis and inflammation was higher in the roller pump group (G1).
ReBEC (RBR-92b9dg).
比较接受冠状动脉搭桥手术的患者使用两种主要类型的体外循环（离心泵和滚压泵）时围手术期溶血和炎症反应的发生率，并建立溶血和炎症变化之间的相关性。
这是一项前瞻性随机试验，60例患者被随机分配接受滚压泵（G1组，n = 30）或离心泵（G2组，n = 30）体外循环。测量并分析溶血标志物（血清触珠蛋白、乳酸脱氢酶[LDH]）和炎症标志物（白细胞介素[IL]1β、IL - 6和肿瘤坏死因子-α）。
感兴趣的变量在组间无显著差异。在G1组中，触珠蛋白与IL - 6和肿瘤坏死因子-α呈正相关（分别为P < 0.01和P < 0.05）。在G2组中，术后LDH呈正相关（P < 0.5）。体外循环后24小时，G1组中LDH与IL - 1β（P < 0.05）、LDH与肿瘤坏死因子-α（P < 0.01）、触珠蛋白与肿瘤坏死因子-α（P < 0.05）以及LDH与肿瘤坏死因子-α（P < 0.01）之间呈正相关，G2组中LDH与IL - 6（P < 0.01）、LDH与肿瘤坏死因子-α（P < 0.01）以及LDH与IL - 6（P < 0.01）之间呈正相关。
溶血或炎症标志物在组间无显著差异。G1组中IL - 6和肿瘤坏死因子-α与体外循环时间呈正相关，而G2组中LDH与体外循环时间呈正相关。滚压泵组（G1组）溶血和炎症标志物之间显著关联的发生率更高。
ReBEC（RBR - 92b9dg）。
