Effects of combination of ultrafiltration of routine and improved method on the expression of cytokines and cell adhesion molecules in perioperative period of cardiopulmonary bypass in children
Objective:To investigate the changes of soluble cytokines and cell adhesion molecules in perioperative period of cardiopulmonary bypass(CPB) and to evaluate the effects of combined ultrafiltration on the expression of cytokines and cell adhesion molecules following CPB in children. Methods: Nineteen children with congenital heart disease were randomly divided into a control group(n = 10) and combined ultrafiltration(n = 9). Plasma levels of interleukin-6, interleukin-8, ICAM-1 and VCAM-1 were assessed. Results: The plasma levels of IL-6, IL-8,ICAM-1, VCAM-1 increased to peak value at the end of CPB. The use of combined ultrafiltration could lower the plasma levels of IL-6, IL-8 and ICAM-1. There were significant differences between the two groups at the end of CPB(P < 0.05, P < 0.01, P < 0.05 respectively). But the effect of combined ultrafiltration on the plasma level of VCAM-1 was not significant. Conclusion: After hypothermic CPB, cell adhesion molecules and cytokines are significantly increased. Using combined ultrafiltration during and after CPB can not only concentrate blood cell, alleviate the edima of tissues, but also lower the plasma levels of cytokines and adhesion molecules.