Perioperative Changes Of IL-6 In Blood Serum During Deep Hypothermia Cardiopulmonary

Objective:To observe the changing of interleukin-6 and the relationship with delayed recovery of nervous system for patients experiencing deep hypothermia during CPB in the cardiac surgery, including deep hypothermic circulatory arrest (DHCA) subgroup and deep hypothermic circulatory arrest with selective cerebral perfusion (DHCA+ASCP) subgroup.Methods:We selected 24 cases undergoing cardiac surgery with DHCA into the trial. Serum levels Of IL-6 were measured using enzyme-linked immunosorbent assay technique (ELISA) in the points of pre-CPB(T1), pre-DHCA(T2), post-DHCA(T3), 24 hours post operation(T4),48 hours post operation(T5). Based on Glasgow Coma Scale,we divided all patients into two groups, Group A as wakeup during the 24 hours post operation and Group B as delayed recovery more than 24 hours. And based on the methods of cardiopulmonary bypass, we grouped all cases into Group A as DHCA only and Group B as DHCA with ASCP. We used Pearson correlation analysis for analysing the correlation ship and chose P<0.05 as significantly different.Results:Two cases of postoperative deaths were excluded. The serum levels of IL-6 in the time point of post-CPB were higher than the values in the time point of pre-CPB in these cases, but the difference was not statistically significant (P>0.05). And the serum level of IL-6 began to rise at the beginning of CPB, and then rose to the peak value post-DHCA, and then revealed the trends that decreasing until the time point of 48hours post operation, the difference was not statistically significant (P>0.05). The serum levels of IL-6 were positive correlation with the time of CPB, aortic clamping (ACC)and DHCA. The results of subgroups showed that the IL-6 of Group B was increasing more obviously than Group A, and the difference was statistically significant (P<0.05).The levels of IL-6 in Group C in the time point of 24 hours post operation were increasing more obviously than Group D, but the difference was not statistically significant (P>0.05).Conclusions:The results that the serum levels of IL-6 were increasing during cardiac surgery with deep hypothermic cardiopulmonary bypass, indicated that deep hypothermic cardiopulmonary bypass may cause systemic inflammatory response occur. There’s possible correlation between the inflammatory during operation and recovery delayed. And no matter what the methods of CPB, including DHCA only and CPB DHCA with ASCP, the serum levels of IL-6 were increasing post operation, but DHCA with ASCP will decrease the inflammatory response comparing with the DHCA only patients. The time of CPB, ACC and DHCA will affect releasing of IL-6, which will influence the degree of nervous system recovery and inflammatory response post operation. The treatments focused on anti-inflammatory therapy will benefit for the patients with DHCA cardiopulmonary bypass.