The Comparison of Inflammatory Response in Off-Pump and OnPump Coronary Bypass Surgery

Abstract

Objective: In this study, tumor necrosis factor-α (TNF-α) and C-reactive protein (CRP) levelswhich are important in inflammatory response to off pump and on pump coronary by-passsurgery, were compared and their clinical reflections were examined.Study plan: Forty patients who underwent coronary artery by-pass grafting in our clinic, wereincluded in the study. The first group included on-pump patients (Group I, n=20) and secondgroup included off pump patients (group II, n=20). In both groups the day before surgery andpost operative sixth hour of tumor necrosis factor, as well as the day before surgery, postoperative first and third days of C - reactive protein levels were measured.Results: In the comparison of TNF- α levels, while the preoperative levels were not significantlydifferent in both groups (p=0.098), postoperative levels of Group 1 were significantly higher(p=0.016). In both groups any significant difference between pre operative CRP levels (p=0.074)was not found. In Group I, the first and third postoperative day CRP levels were significantlyhigher (p=0.021-p=0.019). White blood cell levels of each group at preoperative (p=0.094), postoperative 1st day (p=0.091) and post operative 3rd day (p=0.095) were not significantlydifferent.Conclusion: As an indicator of inflammatory response, the tumor necrosis factor- α and Creactive protein levels were significantly higher in operations using cardiopulmonary by-passthan surgeries on beating heart

Keywords

• Off-pump coronary surgery, On-pump Coronary Surgery, Inflammatory Response

Off-Pump ile On-Pump Koroner Bypass Cerrahisinde İnflamatuar Yanıtın Karşılaştırılması

Abstract

Amaç: Bu çalışmamızda off-pump ve on-pump yöntemi ile koroner bypass operasyonu yapılanhastalardaki inflamatuar yanıtta önemli olan tümör nekrozis faktör-alfa (TNF-α) ile C–reaktifprotein (CRP) değerleri karşılaştırılarak klinik yansımaları incelenmiştir.Çalışma planı: Kliniğimizde koroner bypass operasyonu yapılan 40 hasta çalışmaya alındı.Birinci grup on- pump hastaları (Grup I, n=20), ikinci grup ise off pump (Grup II, n=20)hastalarından oluşturuldu. Her iki grupta operasyondan bir gün önce ve postoperatif 6.saattetümör nekrozis faktör, ayrıca operasyondan bir gün önce, postoperatif 1. ve 3. günlerde C-reaktifprotein ile akyuvar düzeylerine bakıldı.Sonuçlar: Karşılaştırdığımız tümör nekrozis faktör düzeylerinde preoperatif dönemde anlamlıbir fark izlenmezken (p=0.098), postoperatif dönemdeki tümör nekrozis faktör düzeyleri GrupI’de anlamlı olarak daha yüksek bulundu (p=0.016). Her iki gruptaki preoperatif C-reaktifprotein düzeyleri arasında anlamlı bir fark bulunmazken (p=0.074), Grup I’de postoperatif 1.ve 3. gündeki C-reaktif protein düzeyleri anlamlı olarak daha yüksek bulundu (p=0.021 p:0.019). Her iki grubun preoperatif (p=0.094), postoperatif 1.gün (p=0.091) ve postoperatif3.gün (p=0.095) white blood cell düzeyleri arasında istatistiksel olarak anlamlı bir farksaptanmadı.Tartışma: Kardiyo-pulmoner by-pass kullanılarak yapılan operasyonlarda inflamatuar yanıtınbir göstergesi olan tümör nekrozis faktör ve C-reaktif protein düzeyleri atan kalpte yapılanlaraoranla anlamlı derecede yüksek bulunmuştur

Keywords

• Off-Pump Koroner Cerrahi, On-Pump Koroner Cerrahi, İnflamatuar Yanıt

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