Efecto del purgado de la bomba de circulación extracorpórea con coloides o cristaloides sobre la concentración de las proteínas de fase aguda después de la cirugía cardíaca
- Tamayo Gómez, Eduardo
- Alonso Ardid, Oscar
- Bustamante Bustamante, Maria Rosa
- Álvarez González, Francisco Javier
- Flórez, S.
- Soria, S.
- Lajo, C.
- Rodríguez, R.
ISSN: 1139-8264
Ano de publicación: 2008
Volume: 11
Número: 1
Páxinas: 26-32
Tipo: Artigo
Outras publicacións en: Revista española de investigaciones quirúrgicas
Resumo
OBJETIVE. 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 and reduces the protein plasma levels in the acute phase. METHODS. A prospective study was designed. Forty four patients undergoing elective coronary artery bypass grafting were allocated to one of two groups: 22 patients primed with Ringer�s lactate solution and 22 patients primed with gelatin-containing solution during coronary artery bypass surgery. Plasma levels of interleukin IL-6, C-reactive protein, complement 4, and SIRS score were measured during the surgical intervention and over the following 48 postoperative hours. Interleukine 6 levels were measured by enzyme-linked, total C4 and CRP were determined by nephelometry. RESULTS. No significant differences were noted between the two groups with respect to the perioperatory variables, the acute-phase protein levels, or the post-cardiopulmonary bypass complications. In both groups, compared with the initial levels, IL-6 levels peaked at 6 hrs after surgery and CRP at 48 hrs. Complement 4 levels decreased from the start of the cardiopulmonary bypass and returned progressively toward the baseline value at 48 hrs after surgery. CONCLUSIONS. Priming with gelatin versus Ringer�s lactate produces no significant differences in the inflammatory response in patients undergoing coronary artery bypass grafting with cardiopulmonary bypass.