• Top
• Introduction
• Methods
• Results
• Conclusion

Introduction

Cardiopulmonary bypass (CPB) is associated with systemic inflammation that involves a number of cytokines, and, despite scarce data, macrophage chemoattractant protein 1 (MCP-1) could be implicated in postoperative organ dysfunction. This pilot study attempted to describe perioperative circulating levels of MCP-1 and to investigate possible correlations with the intensity of postoperative organ dysfunction.

Methods

Under informed consent, 20 patients submitted to cardiac surgery with CPB were consecutively studied. MCP-1, macrophage migration inhibitory factor (MIF), IL-6 and IL-10 were assayed by ELISA in peripheral blood sampled at anesthesia induction and 3, 6, 10 and 24 hours post-CPB. Data were analyzed by ANOVA for repeated measures with the Bonferroni test, and the two-tailed Spearman test for correlations with postoperative outcomes, as measured by the multiple organ dysfunction score at the third postoperative day (MODSd3). Significance was assumed for P < 0.05.

Results

Similar to MIF and IL-6, blood levels of MCP-1 significantly changed after CPB. From baseline levels (69.44 ± 15.92 pg/ml), MCP-1 reached peak values 3 hours post-CPB (387.11 ± 108.87 pg/ml), and progressively declined thereafter. MODSd3 was associated with the levels of MCP-1 measured at anesthesia induction (P = 0.010, rho = 0.606) and at 6 hours post-CPB (P = 0.037, rho = 0.508). Levels of IL-6, 6 hours post-CPB, were also associated with MODSd3 (P = 0.008, rho = 0.616).

Conclusion

CPB-induced levels of MCP-1 and IL-6 were related to postoperative outcome. Additionally, preoperative levels of MCP-1 were also related to postoperative outcome. Although of limited sample size, these findings can stimulate further studies to explore the role of MCP-1 in the prediction of, and also as a potential therapeutic target in, post-CPB organ failure.

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