Effects of Cardiopulmonary Bypass on Cytokines

Öz

Introduction: There are significant differences between the normal physiological functioning of the heart and the extracorporeal circulation. During extracorporeal circulation, blood comes into contact with artificial material surfaces other than the vascular endothelium. During and after contact, changes occur in metabolism, blood, tissues and immune system. This can cause different reactions in the body, causing the release of cytokines. Aim: The aim of this study is to investigate the effect of cardiopulmonary bypass (CPB) on cytokines in cardiac surgery operations performed with CPB. Methods: Fifteen male and 15 female patients who had undergone cardiac surgery with CPB and 30 healthy individuals with similar demographic characteristics were included in the study as the control group. Vascular endothelial growth factor (VEGF) levels were studied from the blood samples taken from the patients at 5 different times and from the control group. The results were evaluated statistically. Results: In this study; There was a statistically significant difference between VEGF levels of blood samples taken at different times from healthy volunteers (Control group) and patients (p=0.045). Conclusion: As a result of the study, we think that there was a significant decrease in VEGF levels during and after CPB, due to reasons such as surgical trauma, priming solution, cardioplegia drugs and extracorporeal circulation equipment. It was found that it increased above the normal level in the postoperative period. We think that extracorporeal circulation equipment may cause inflammatory response in cardiac surgery performed with CPB, which causes a serious increase in VEGF level in the postoperative period.

Anahtar Kelimeler

• Cardiopulmonary Bypass
• Cytokines
• VEGF

Kardiyopulmoner Bypassın Sitokinler Üzerine Etkisi

Öz

Giriş: Kalbin normal fizyolojik çalışma durumu ile ekstrakorporeal dolaşım arasında önemli farklılıklar vardır. Ekstrakorporeal dolaşım sırasında, kanın vasküler endotelden farklı yapay materyal yüzeylerle temas etmektedir. Temas sırasında ve sonrasında metabolizmada, kanda, dokularda ve immün sistemde değişiklikler oluşmaktadır. Buda vücutta değişik reaksiyonlara yol açarak, sitokinlerin salınımına neden olabilmektedir. Amaç: Yapılan bu çalışmanın amacı kardiyopulmoner bypass (KPB) eşliğinde yapılan kardiyak cerrahi operasyonlarında KPB'ın sitokinler üzerine etkisini araştırmaktır. Yöntem: Çalışmaya KPB eşliğinde kardiyak cerrahi geçirmiş 15 erkek, 15 kadın hasta ve benzer demografik özelliklerde 30 sağlıklı birey kontrol grubu olarak dahil edildi. Hastalardan 5 farklı zamanda ve kontrol grubundan alınan kan numunelerinden ''Vasküler endotelyal büyüme faktörü (VEGF)'' düzeyleri çalışıldı. Sonuçlar istatistiksel olarak değerlendirildi. Bulgular: Bu çalışmada; sağlıklı gönüllülerden (Kontrol grubu) ve hastalardan farklı zamanlarda alınan kan numunelerinin VEGF düzeyleri arasında istatistiksel olarak anlamlı fark vardı (p=0,045). Sonuç: Çalışma sonucunda KPB sırasında ve KPB çıkışında VEGF seviyesinde anlamlı şekilde düşüş olduğu, bunun da cerrahi travma, prime solüsyonu, kardiyopleji ilaçları ve ekstrakorporeal dolaşım ekipmanı gibi nedenlere bağlı olduğunu düşünmekteyiz. Postoperatif servise çıkış dönemde ise normal seviyenin üzerine yükseldiği saptanmıştır. KPB eşliğinde yapılan kardiyak cerrahide ekstrakorporeal dolaşım ekipmanlarının inflamatuar yanıta neden olabileceğini bunun da postoperatif dönemde VEGF seviyesinde ciddi düzeyde yükselmeye neden olduğunu düşünmekteyiz.

Anahtar Kelimeler

• Kardiyopulmoner Bypass
• Sitokinler
• VEGF

Kaynakça

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