Influence of different treatment to the residual blood after cardiopulmonary bypass on the inflammation after operation

Objective: To explore the different treatment to the residual blood in the conduit after cardiopulmonary bypass (CPB) on the inflammation after coronary artery bypass grafting with CPB. Methods: Between July 23 rd ,2001 and November 22 nd,2001, 24 patients who continuously took selective CABG with cardiopulmonary bypass in our hospital were divided randomly into experiment group (autotransfusion group, AT group) and control group (non AT group), 12 patients in each group. In AT group, the residual blood in circulation conduit after CPB was processed with ATS, whereas the residual blood was retransfused directly to patients in nonAT group. The blood samples were drew in all patients at (1)right after anesthesia, (2)1 h after CPB, (3)6 h after CPB, (4)24 h after CPB and (5)48 h after CPB to determinate the levels of sC 5b-9, IL-6 and TNFα , and we also drew blood samples before and after the process of residual blood in AT group to determinate the levels of Hb, Hct, sC 5b-9, IL-6 and TNFα. All data were adjusted by Hct. Results: All patients survived. There was no difference in the levels of Hb, Hct, ALB between two groups 24 hours after operation. After ATS process, the levels of sC 5b-9, IL-6 and TNFα in residual blood were significantly decreased. The levels of sC 5b-9 were significantly lower 6 h after CPB, 24 h after CPB and 48 h after CPB in AT group than in nonAT group. There were no differences in the levels of TNFα between two groups all the time, but the alternate ratio of IL-6 at 48 h after CPB was markedly lower in AT group. Neutrophil count was significantly lower 48 h after CPB in AT group than in nonAT group. Conclusion: The process of ATS can remove a majority of cytokines and activated components of complement system in residual blood in conduit after CPB. There is no obvious hypoproteinemia after transfusion of the processed residual blood. Transfusion of the processed residual blood can partly reduce the levels of inflammation medium and relieve the inflammation after cardiopulmonary bypass.