Comparison Of The Inflammatory Cytokines Level Between Miniaturized Tubing Group And Conventional Tubing Group In CHD Cardiopulmonary Bypass

Objective: To adapt to the trend of younger age and lower body weight infants undergoing open heart surgery,and to reduce the inflammatory reaction in cardiopulmonary bypass(CPB),we employed miniaturized cardiopulmonary bypass system.We aimed to compare the inflammatory cytokines level of the miniaturized and conventional cardiopulmonary bypass systems.In order to further study the feasibility and safety of the miniaturized cardiopulmonary bypass strategy in open heart surgery for children.Method: We performed a prospective randomized controlled trial(RCT)of all patients undergoing open heart surgery with CPB(weight≤ 15 kg,age≤2)in our center from 1 October 2020 to 31 December 2021.Exclusion criteria: 1.Patients with pneumonia or other infected diseases;2.Patients with diseases of other systems;3.Patients who need emergency operation;4.Patients with heart failure;5.Patients with liver or kidney insufficiency.Patients who were included were divided into two groups randomly by random data form.One group would adopt conventional CPB system and the other group would adopt miniaturized CPB system.Blood samples were collected in 5 different time points in all patients,which are right after anesthesia.5 minutes after heparin neutralization when CPB was done,6 hours after CPB was done,12 hours after CPB was done,and 24 hours after CPB was done.IL-6,IL-8,and TNF alpha were respectively tested with Abcam ELISA kit.The results were documented from the Thermo Scientific Microplate Reader.SPSS24 were used for data analysis.Measurement data were expressed as mean±standard deviation(x±s)or median(interquartile spacing)[M(P25,P75)].Comparison between the two groups was performed by T-test or Wilcoxon rank sum test.Enumeration data were expressed as frequency and percentage [n(%)],and comparison between groups was performed by Chi-square test or Fisher’s exact.Results: Of the 101 patients,40(39.6%)were in the conventional CPB group,and 61(60.4%)were in the miniaturized CPB group.The inflammatory cytokines level of IL-8 and TNF alpha was significantly lower in the miniaturized CPB group in multiple time points compared with that in the conventional CPB group.Compared with the conventional CPB group,the miniaturized CPB group also has a lower blood transfusion rate(p=0.009).Conclusion: Implementing the miniaturized CPB system could decrease the inflammatory cytokines in certain level and also decrease the blood transfusion rate.This indicates the miniaturized CPB system can be a safer CPB strategy with fewer possible inflammation-induced complications.