Methylprednisolone inhibits increase of interleukin 8 and 6 during open heart surgery |
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Authors: | Takae Kawamura Katsuya Inada Hiroshi Okada Kazutoshi Okada Reiji Wakusawa |
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Institution: | 1. Department of Anesthesiology, Iwate Medical University, 19-1, Uchimaru, Morioka, 020, Iwate, Japan
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Abstract: | It has been reported that interleukin 8 (IL-8) and interleukin 6 (IL-6) are two of the chemical mediators causing myocardial injury. It is not clear whether treatment with corticosteroids in vitro in these patients can prevent the production of interleukin 8 and 6. This prospective study was conducted to investigate whether methylprednisolone (MP) pretreatment (30 mg · kg?1 before CPB and before declamping of aorta) influenced the production of IL-8 and 6 in the peripheral circulation in 27 patients undergoing elective coronary artery bypass surgery. The IL-8 and IL-6 concentrations were measured by ELISA kit. We also studied the effect of MP pretreatment on postoperative cardiac Junction. Serum concentration of IL-8 in non-MP-treated patients (37 ± 44 pg · ml?1 preoperatively) increased to 169 ± 86 pg · ml?1 60 min after declamping of the aorta (P < 0.001). The increase was greater than the increase from 22 ± 8.9 pg · ml?1 to 52 ± 35 pg · ml?1 in the MP-treated patients (P < 0.01). Serum IL-6 concentration in non-MP-treated patients increased from the preoperative value of 59 ± 30 pg · ml?1 to 436 ± 143 pg · ml?1 60 min after declamping of the aorta (P < 0.001). The increase was greater than the increase from 36 ± 15 pg · ml?1 to 135 ± 55 pg · ml?1 in the MP-treated patients (P < 0.01). Furthermore, postoperative cardiac index in MP-treated patients (3.6 ± 1.1 L · min?1· m?2) was higher than 2.3 ± 0.8 L · min?1 · m?2 of non MP-treated patients (P < 0.05). The levels of IL-8 max during surgery correlated negatively with postoperative cardiac index (γ = ?0.67). These results suggest that methylprednisolone suppresses production of IL-8 and 6. |
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Keywords: | heart: reperfusion injury" target="_blank">heart: reperfusion injury hormones: cytokines" target="_blank">hormones: cytokines interleukins methylprednisolone anaesthesia: cardiac" target="_blank">anaesthesia: cardiac cardiopulmonary bypass |
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