Elsevier

Cytokine

Volume 8, Issue 12, December 1996, Pages 944-948
Cytokine

Regular article
RELEASE OF SOLUBLE TUMOUR NECROSIS FACTOR ALPHA RECEPTORS DURING AND AFTER PAEDIATRIC CARDIOPULMONARY BYPASS. CORRELATION WITH HAEMODYNAMIC AND CLINICAL VARIABLES

https://doi.org/10.1006/cyto.1996.0127Get rights and content

Abstract

The release of cytokines during cardiopulmonary bypass (CPB) may contribute to haemodynamic alternations encountered after open heart surgery. Regulatory mechanisms exist and include soluble cytokine receptors. We have measured blood levels of tumour necrosis factor (TNF) and its soluble receptor (TNFsr) during and after open heart surgery in children. Correlation analysis to haemodynamic and clinical variables was performed.

Using immunoassays the authors registered a significant increase in plasma levels of TNFsr with peak levels 2 h post?operatively at a level of 1702 ± 170 pg/ml. The concentration of TNFsr remained significantly elevated until 48 h postoperatively but TNF was not significantly elevated.

An inverse correlation existed between peak TNFsr and mean arterial pressure (rho = −0.827,P< 0.05), between TNFsr and cardiac index (rho = −0.8,P< 0.05), between TNFsr and left ventricular stroke work index (rho = −0.983,P< 0.01), between TNFsr and weight (rho = −0.85,P< 0.05) and between TNFsr and body surface area (rho = −0.867,P< 0.05).

The authors demonstrate that the smallest children experienced the highest TNFsr concentration post-operatively. Furthermore cardiac performance, expressed as cardiac index and left ventricular stroke work index, correlated inversely to peak TNFsr level post-operatively.

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    The literature on TNF-α levels during cardiacsurgery with CPB is controversial.10 TNF-α has beenfound to be systemically elevated during and after, CPB,111 especially in pediatric cardiacsurgery.11 Others12 observed no increaseduring cardiac surgery.

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