Interleukin-6 Enhancement after Direct Autologous Retransfusion of Shed Thoracic Blood does not Influence Haemodynamic Stability Following Coronary Artery Bypass Grafting

S. Schroeder; T. von Spiegel; F. Stuber; A. Hoeft; C. J. Preusse; A. Welz; S. Kampe; H. Lier

doi:10.1055/s-2006-924655

The Thoracic and Cardiovascular Surgeon, Table of Contents

Thorac Cardiovasc Surg 2007; 55(2): 68-72
DOI: 10.1055/s-2006-924655

Original Cardiovascular

Interleukin-6 Enhancement after Direct Autologous Retransfusion of Shed Thoracic Blood does not Influence Haemodynamic Stability Following Coronary Artery Bypass Grafting

S. Schroeder¹ , T. von Spiegel¹ , F. Stuber² , A. Hoeft² , C. J. Preusse³ , A. Welz³ , S. Kampe⁴ , H. Lier⁴

¹Department of Anaesthesiology and Intensive Care Medicine, Westküstenklinikum Heide, Heide, Germany
²Department of Anaesthesiology and Intensive Care Medicine, University of Bonn, Bonn, Germany
³Department of Cardiac Surgery, University of Bonn, Bonn, Germany
⁴Department of Anaesthesiology and Intensive Care Medicine, University of Cologne, Cologne, Germany

Abstract

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Abstract

Background: Direct autologous retransfusion of shed thoracic blood is carried out to reduce homologous transfusion after cardiac surgery, but it contains high concentrations of inflammatory mediators. The purpose of the study was to investigate whether retransfusion of shed thoracic blood induces plasma interleukin-6 (IL-6) expression and influences haemodynamics. Methods: Following uncomplicated coronary artery bypass graft surgery, forty-four patients were randomised in case postoperative blood loss via thoracic drains exceeded 350 ml. The course of plasma IL-6 levels and haemodynamics including cardiac output, extravascular lung water and intrathoracic blood volume were investigated prior to (T0), 30 minutes (T1), 1 (T2), 3 (T3) and 12 hours (T4) after retransfusion of 350 ml shed blood in comparison to 350 ml saline. Results: Plasma IL-6 levels at T1 (1892 ± 202 vs. 485 ± 30 pg/ml) and T2 (1059 ± 119 vs. 413 ± 30 pg/ml) were significantly higher in the verum group (n = 20) compared to controls (n = 24) (p < 0.01). Severe haemodynamic side effects were not detected. Conclusion: This study found significantly elevated plasma IL-6 levels following direct autologous retransfusion of shed thoracic blood but failed to show severe adverse effects affecting haemodynamic stability.

Key words

autologous blood transfusion - haemodynamic phenomena - interleukin‐6

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References

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MD Heiko Lier

Department of Anaesthesiology and Intensive Care Medicine
University of Cologne

Kerpener Straße 62

50937 Köln

Germany

Phone: + 49 22 14 78 48 07

Fax: + 49 22 14 78 60 93

Email: heiko.lier@uk-koeln.de