Comparative Study On Systemic Inflammatory Response Syndrome And Myocardial Injury After On-pump And Off-pump Coronary Artery Bypass Grafting

Objective: Objective: To investigate the effect of multiple coronary artery bypass grafting (CABG) with or without cardio pulmonary bypass(CPB) on the perioperative systemic inflammatory response and myocardial injury.Methods: Thirty five patients with Patients with multivessel disease were randomly assigned to two groups: conventional On-pump Coronary Artery Bypass Grafting(CPBCABG) (group A) and Off-pump Coronary Artery Bypass Grafting (OPCABG) (group B). Blood samples of 35 patients were drawn induction period of anaesthesia,2 hours,8 hours,24 hours,and 48 hours after surgery,The plasma inter leukin 6(IL-6),IL-8,TNF-α,cTNI were measured. Overall,incidence of infection and perioperative clinical outcome was also recorded.Results: There were no significant differences in terms of age,sex,weight,extent of coronary disease,left ventricular function,volume of blood transfasion and number of grafts per-patient between the two groups. IL-6 in 2 hours,8 hours after surgery and TNF-αin 2 hours after surgery increased significantly than that in induction period of anaesthesia in the patients of group B(P<0.05 or P<0.01),all facts increased significantly after surgery in the patients of group A,espaily in 2 hours,8 hours and 24 hours after surgery (P<0.05 or P<0.01). IL-6,IL-8,TNF-αand cTNI increased significantly after surgery in the patients of group A than that in group B(P<0.05). The durations of post operative mechanical ventilation were shorter in the OPCABG Group than those in the CPBCABG group, so were the durations of fever.Conclusion: Off-pump coronary bypass grafting significantly reduces the inflammatory reaction and myocardial injury associated with the use of CPB.