Effects of Aprotinin on TNF-α levels after cardiopulmonary bypass

Objective: This study evaluates the anti inflammatory activity of full dose and pump prime only(low dose) aprotinin by means of comparing tumor necrosis factor α(TNF α) levels of both groups after CPB. Methods: Twenty nine adults with rheumatic heart disease were randomized into three groups: (1)full dose aprotinin treated group(Group A, n=10); (2)pump prime only aprotinin treated group(Group B, n=10), and (3) control group(Group C, n=9). Plasma concentrations of TNF α were measured by enzyme linked immunosorbent assay technique at baseline(before operation), and at 2,24 hours after CPB termination. Results: A significant(P0.05) increase of TNF α occurred in all three groups at 2 and 24 hours after CPB termination when compared with the same group at baseline. In Group A, TNF α level was significantly lower than that in group C(P0.05) at 24 hours after CPB, but not in group B(P0.05). Conclusions: Both CPB and operative stimulus induce the increase of cytokine TNF α after CPB. Full dose aprotinin has the anti inflammatory effect by means of reducing TNF α level after CPB. Low dose aprotinin dose not reduce TNF α level. So it no significant anti inflammatory effect. [