[Effects of cardiopulmonary bypass on plasma pentraxin-3 level and the balance of Th1/Th2 function in children with congenital heart malformations].

OBJECTIVE: To investigate the effects of cardiopulmonary bypass (CPB) on plasma pentraxin-3 (PTX3) level and balance of Th1/Th2 function in children with congenital heart malformations. METHODS: 16 children with congenital heart malformations, 9 male and 7 female, aged 3 - 52 months, weighing 3.4 - 14.5 kilograms, classified as II or III ASA grades, underwent operation under CPB. Blood samples were collected after anesthesia induction, 5 min and 30 min since beginning of CPB, and 5 min, 2 h, 4 h, 8 h, and 16 h after weaning from CPB. ELISA was used to examine the plasma concentrations of interferon (INF)-gamma, interleukin (IL)-4, and PTX3. The ratio of INF-gamma/IL-4 was calculated. RESULTS: The INF-gamma level began to increase significantly 5 min since CPB (P < 0.05), peaked 5 min after weaning from CPB (P < 0.01), then gradually decreased, and returned to the level before CPB 16 h after the weaning from CPB (P > 0.05). The IL-4 level began to increase significantly 30 min since CPB (P < 0.01), peaked 2 h since CPB (P < 0.01), however, still not returned to the level before CPB 16 h after the weaning from CPB (P < 0.05). The PTX-3 level was significantly higher 30 min since CPB and 5 min and 2 h after the weaning from CPB (all P < 0.01). The INF-gamma/IL-4 ratio was significantly higher 5 min and 30 min since CPB and 5 min after weaning from CPB (all P > 0.05). CONCLUSION: CPB can leads to elevation of plasma concentration of PTX3 and drift of Th1/Th2 function equilibrium, thus resulting in immunity disequilibrium.

Antioxidative effect of propofol during cardiopulmonary bypass in adults.

AIM: To investigate the antioxidative potential of propofol (an intravenous anesthetic with a chemical structure similar to phenol-based free radical scavengers such as vitamin E) during cardiopulmonary bypass (CPB). METHODS: Thirty adult patients referred for elective cardiac procedure with CPB were included and randomly allocated to a propofol group or a control group. Patients in the propofol group received propofol (0.1 mg/kg/min) intravenously for anesthesia maintenance, whereas those allocated to the control group received fentanyl 10 microg/kg intravenously and inhaled enflurane (1 %-1.5 %). Blood samples were collected at 7 time points: before the start of CPB, at 30 and 60 min of CPB, at the conclusion of CPB, 10 min after the administration of protamine, and 12 and 24 h after the cessation of CPB. Plasma levels of free F2-isoprostanes (sensitive markers of free radicals production) and complement C5a were determined by mass-spectrometric assay and enzyme immunoassay, respectively. Neutrophil adhesion to endothelial cells was observed at 200 magnification under a light microscope. RESULTS: Levels of F2-isoprostanes, complement C5a and neutrophil adhesion rate increased significantly during and after CPB in both groups. There were significantly higher levels of F2-isoprostanes, C5a, and more neutrophils adhering to endothelial cells in the control group than those in the propofol group, respectively. CONCLUSION: Cardio-pulmonary bypass is associated with a great production of damaging free radicals. Propofol may be beneficial both as an anesthetic and as a potent free radical scavenger in patients presenting pathologies associated with free radical reactions during CPB.