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Journal of Cardiovascular Medicine and Surgery

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Impact of Perioperative Pentoxifylline Treatment on Cardiopulmonary Bypass Induced Inflammatory Response: A Randomized Controlled Trial

Sambhunath Das , Sambhunath Das , Akshya K. Bisoi , R. Lakshmy , Neeti Makhija , Usha Kiran

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Journal of Cardiovascular Medicine and Surgery 1(2):p 69-73, . | DOI:
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Abstract

 Background: The frequent occurrence of bypass induced systemic inflammation after coronary artery bypass grafting (CABG) is a major concern for scientists. Various attempts in attenuating the inflammation have been tried. Recently few studies showed that pentoxifylline (PTF) treatment reduces inflammation from cardiopulmonary bypass (CPB). The perioperative use of PTF on inflammatory response was estimated by measuring biomarkers of inflammation. Objectives: To evaluate the effect of PTF on biomarker of inflammation in patients undergoing CABG using CPB. Methods: Sixty patients age between 40-65 years scheduled for CABG surgery using CPB were included in the study. The study group was administered PTF (Group I) 400 mg twice daily orally from the day of admission to 6th day after surgery. Whereas the control group was not administered PTF (Group II). Blood samples were collected perioperatively at 4 points of time; before induction of anaesthesia, after 1h of termination of CPB, 24h after surgery and 6thpost-operative day for interleukin-6 (IL6) and C- reactive protein (CRP) as inflammatory markers. The data was analyzed and P<0.05 was considered significant. Results: The IL-6 and CRP values were similarbefore induction of anaesthesia (p= 0.473 and p=0.315) between two groups. The PTF treated group had lesser rise in the level of IL-6 (51.38±30.04 vs 119.74±103.86. p<0.017; 69.70±23.60 vs 135.72±88.19, p<0.002; 12.11±5.65 vs 40.20±30.58; p< 0.000) and CRP (6.04±2.88 vs 8.83±2.9, p< 0.000; 158.79±42.37 vs 223.87±93.00, p<0.004; 92.70±33.07 vs 184.52±117.82, p< 0.000) compared to control group patients after 1h of termination of CPB, 24h after surgery and 6thpost-operative day. Conclusions: Pentoxifylline attenuates rise in level of IL6 and CRP due to cardiac surgery. Hence perioperative treatment of pentoxifylline will reduce inflammatory reaction in patients undergoing CABG with CPB.  

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  • Sambhunath Das
    ,
  • Sambhunath Das
    ,
  • Akshya K. Bisoi
    ,
  • R. Lakshmy
    ,
  • Neeti Makhija
    ,
  • Usha Kiran
    ,
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