Pentoxifylline Affects Cytokine Reaction in Cardiopulmonary Bypass
DOI:
https://doi.org/10.1532/HSF98.20061090Abstract
Background. Cardiac surgery is associated with an inflammatory response that may cause myocardial dysfunction after cardiopulmonary bypass. We examined the efficacy of pentoxifylline to attenuate the cardiopulmonary bypass-induced inflammatory response during heart operations.
Methods. In a prospective, randomized study, 30 patients undergoing coronary artery bypass graft surgery received either pentoxifylline (group P, n = 15) (continuous infusion of 1.5 mg/kg per hour during operation) or not (group C [control], n = 15). Blood samples for measurements of tumor necrosis factor (TNF)-?, interleukin (IL)-6, IL-8, and IL-10 were taken from the arterial line in both groups at 5 different time points.
Results. TNF-?, IL-6, and IL-8 plasma levels increased in both groups after cardiopulmonary bypass, with a higher increase in the control group (P < .05).
Conclusions. Our results indicate that pentoxifylline infusion during cardiac surgery inhibits the proinflammatory cytokine release caused by cardiopulmonary bypass.
References
Al-Ruzzeh S, Hoare G, Marczin N, et al. 2004. Off-pump coronary artery bypass surgery is associated with reduced neutrophil activation as measured by the expression of CD11b. Heart Surg Forum 6:89-93.nAleshin A, Sawa Y, Ono M, Funatsu T. 2004. Myocardial protective effect of FR167653; a novel cytokine inhibitor in ischemic-reperfused rat heart. Eur J Cardiothorac Surg 26:974-80.nAmbrus JL, Stadler S, Kulaylat M. 1995. Hemorrheologic effects of metabolites of pentoxifylline (Trental). J Med 26:65-75.nBittar MN, Carey JA, Barnard J, et al. 2005. Interleukin 6 G-174C polymorphism influences outcome following coronary revascularization surgery. Heart Surg Forum 8:E140-5.nBoldt J, Brosch C, Lehmann A, Haisch G, Lang J, Isgro F. 2001. Prophylactic use of pentoxifylline on inflammation in elderly cardiac surgery patients. Ann Thorac Surg 71:1524-9.nEl Azab SR, Rosseel PMJ, de Lange JJ, Groenveld ABJ. 2002. Dexamet-hazone decreases the pro- to anti-inflammatory cytokine ratio during cardiac surgery. Br J Anaesth 88:496-501.nEdmunds LH Jr. 1997. Extracorporeal perfusion. In: Edmunds LH Jr, ed. Cardiac Surgery in the Adult. New York: McGraw-Hill; 255-94.nEdmunds NJ, Lal H, Woodward B. 1999. Effects of tumour necrosis factor-alpha on left ventricular function in the rat isolated perfused heart: possible mechanisms for a decline in cardiac function. Br J Pharmacol 126:189-96.nEge T, Arar C, Canbaz S, et al. 2004. The importance of aprotinin and pentoxifylline in preventing leukocyte sequestration and lung injury caused by protamine at the end of cardiopulmonary bypass surgery. Thorac Cardiovasc Surg 52:10-5.nFrangogiannis NG, Smith CW, Entman ML. 2002. The inflammatory response in myocardial infarction. Cardiovasc Res 53:31-47.nGessler P, Pfenninger J, Pfammatter JP, Carrel T. 2003. Plasma levels of interleukin-8 and expression of interleukin-8 receptors on circulating neutrophils and monocytes after cardiopulmonary bypass in children. J Thorac Cardiovasc Surg 126:718-25.nGiomarelli P, Scolletta S, Borrelli E, Biagioli B. 2003. Myocardial and lung injury after cardiopulmonary bypass: role of interleukin (IL)-10. Ann Thorac Surg 76:117-23.nGol MK, Nisanoglu V, Iscan Z, et al. 2002. Inhibition of systemic inflammatory response with sodium nitroprusside in open heart surgery. J Cardiovasc Surg 43:803-9.nJi Q, Zhang L, Jia H, Xu J. 2004. Pentoxifylline inhibits endotoxin-induced NF-kappa B activation and associated production of proinflammatory cytokines. Ann Clin Lab Sci 34:427-36.nLaffey JG, Boylan JF, Cheng DC. 2002. The systemic inflammatory response to cardiac surgery: implications for the anesthesiologist. Anes-thesiology 97:215-52.nLarmann J, Theilmeier G. 2004. Inflammatory response to cardiac surgery: cardiopulmonary bypass versus non-cardiopulmonary bypass surgery. Best Pract Res Clin Anaesthesiol 18:425-38.nMiller BE, Levy JH. 1997. The inflammatory response to cardiopulmonary bypass. J Cardiothorac Vasc Anesth 11:355-66.nSamankatiwat P, Samartzis I, Lertsithichai P, Stefanou D. 2003. Leucocyte depletion in cardiopulmonary bypass: a comparison of four strategies. Perfusion 18:95-105.nSchmartz D, Tabardel Y, Preiser JC, Barvais L. 2003. Does aprotinin influence the inflammatory response to cardiopulmonary bypass in patients? J Thorac Cardiovasc Surg 125:184-90.nSzefner J. Control and treatment of hemostasis in cardiovascular surgery. 1995. The experience of La Pitie hospital with patients on total artificial heart. Int J Artif Organs 18:633-48.nTsang GM, Allen S, Pagano D. 1996. Pentoxifylline preloading reduces endothelial injury and permeability in cardiopulmonary bypass. Asaio J 42:429-34.nUstunsoy H, Sivrikoz MC, Tarakcioglu M, Bakir K. 2006. The effects of pentoxifylline on the myocardial inflammation and ischemia-reperfusion injury during cardiopulmonary bypass. J Card Surg 21:57-61.nWan S, LeClerc JL, Vincent JL. 1997. Inflammatory response to cardiopulmonary bypass. Chest 112:676-93.n
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