Preoperative oral pentoxifylline for management of cytokine reactions in cardiac surgery
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Date
2009
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Abstract
Background: Cardiopulmonary bypass may lead to many inflammatory responses that may cause myocardial dysfunction after open heart surgery. We aimed to investigate the effect of preoperative pentoxifylline treatment to reduce the occurrence of cardiopulmonary bypass-induced inflammatory response. Methods: In a prospective, randomized study, 40 patients undergoing coronary artery bypass graft surgery received either pentoxifylline (study group, n = 21) or not (control group, n = 19). Pretreatment with pentoxifylline (800 mg/day orally) was started 5 days before the operation. Blood samples for measurements of tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8 from the arterial line, and venous blood samples for creatine kinase (CK) and CK isoenzyme fraction MB (CK-MB) were taken in both groups at 5 different time points. Hemodynamic parameters were measured with the thermodilution technique. Results: TNF-α, IL-6, and IL-8 plasma levels increased in both groups after cardiopulmonary bypass, with a greater increase in the control group (P < .05). There were no significant differences between the groups for the values of CK-MB and hemodynamic parameters. Conclusions: We conclude that pretreatment with oral pentoxifylline before cardiac surgery inhibits proinflammatory cytokine release caused by cardiopulmonary bypass and has some beneficial effects in protecting the myocardium during the cardioplegic arrest period in open-heart surgery, without affecting postoperative hemodynamics. © 2009 Forum Multimedia Publishing, LLC.
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Administration, Oral , Cardiopulmonary Bypass , Cytokines , Female , Free Radical Scavengers , Humans , Male , Middle Aged , Myocarditis , Pentoxifylline , Premedication , Preoperative Care , Treatment Outcome , creatine kinase , creatine kinase MB , interleukin 6 , interleukin 8 , pentoxifylline , tumor necrosis factor alpha , cytokine , pentoxifylline , scavenger , adult , arterial blood , article , biochemistry , blood sampling , cardioplegia , clinical article , clinical assessment , controlled study , coronary artery bypass graft , cytokine release , drug effect , female , heart protection , hemodynamic parameters , human , inflammation , male , preoperative treatment , priority journal , protein blood level , surgical technique , thermodilution , venous blood , blood , cardiopulmonary bypass , clinical trial , controlled clinical trial , methodology , middle aged , myocarditis , oral drug administration , premedication , preoperative care , randomized controlled trial , treatment outcome