POTENTIAL ROLE AS A PROINFLAMMATORY CYTOKINES IN POSTOPERATIVE SEVERE SYSTEMIC INFLAMMATORY RESPONSE SYNDROME UNDERGOING HEART VALVE REPLACEMENT SURGERY

Introduction. The prognostic and diagnostic value of measuring concentrations of acute phase reactants in the postoperative period in patients undergoing cardiac valve replacement surgery during cardiopulmonary bypass is not clear now.

Materials аnd metods. Serum levels of inflammatory markers (procalcitonin (PCT), tumor necrosis factor α (TNFα), interleukin-1β (IL-1β), interleukin-6 (IL-6)) were measured quantitatively by ELISA. Blood samples from 71 patients with a diagnosis of infective endocarditis undergoing cardiac valve replacement surgery during cardiopulmonary bypass were taken preoperatively, on the first and seventh day after surgery. Were measured serum concentration and correlated to postoperative clinical course.

Results. Postoperative changes in serum levels PCT, IL-1β and IL-6 significantly increased in patients from groups without postoperative severe SIRS. The serum IL-1β concentrations stay in the preoperatively level at all time points in patients from groups with postoperative severe SIRS. Postoperative IL-6 values on the first day after surgery were significantly lower in patients from groups with postoperative severe SIRS than those in the other group. The serum TNF-α levels significantly increased in patients from all groups at first day after surgery.

Conclusion. The low postoperative levels of IL-1β and IL-6 expected to be the best predictive markers in order to monitor the systemic inflammatory response occurring after cardiac surgery with cardiopulmonary bypass.

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