Postoperative inflammatory reactions after coronary artery bypass grafting performed on-pump with preceding glucocorticoid therapy compared with those after grafting performed off-pump

摘要

BACKGROUND: Compared with conventional coronary artery bypass graft surgery (CABG) using cardio-pulmonary bypass, less postoperative acute inflammatory responses are expected in off-pump CABG. Therefore, we retrospectively studied the difference in postoperative inflammatory reactions between on-pump and off-pump surgical groups. METHODS : We selected 15 patients for on-pump and 19 for off-pump groups, respectively, from the past 3 years. One gram of methylpredonisolone was administered before institution of cardiopulmonary bypass only in the on-pump group. The white blood cell count and the level of C-reactive protein were compared in both groups for 10 days postoperatively. RESULTS : The white blood cell count reached a maximum in each group 2 days after surgery. However the values were significantly greater in the on-pump group than in the off-pump group at postoperative days 3 through 6. The level of C-reactive protein was also increased postoperatively in each group. In the off-pump group without receiving any steroid therapy, the values were greater than in the on-pump group on postoperative days 1 through 6. CONCLUSIONS :In off-pump CABG, the level of C-reactive protein increases significantly in the postoperative period.