The occurence of the Systemic-inflammatory-response-syndrom (SIRS) is one of the main reasons for the letality after coronary bypass grafting. IL-6 is an validated marker for the degree of the SIRS.Former studies have shown a significant release of Interleukin-6 (IL-6) during coronary artery bypass grafting (CABG). The contribution of cardiopulmonary bypass (CPB) and surgical trauma for IL-6-release after CABG is still unknown. Therefore we examined three different types of revascularisation procedures which allowed us to dicrimimate the CPB-induced and operativ-traumatic-induced IL-6 release in CABG. 136 patients were investigated divided in three groups (PTCA, CPB-PTCA, CPB-CABG). Blood samples were obtained via an arterial or venous line before intervention by all patients, by CABG before and ten minutes after opening of the cross clamp; by CPB-PTCA 10 min, 30 min, 1h, 2h after begin of the CPB, and 3h, 6h and the following 4 days after intervention by all patients. Measurement of IL-6 was performed with commercial ELISA test kit. The IL-6 plasma levels increased after intervention in all three groups to a significantly different degree with maximal IL-6 levels between 3 and 24 h after intervention. The levels of the three collectives were significantly different at 3, 6, and 24 h. The highest level was in the CPB-CABG-group with aproximately 500 pg/ml, the IL-6 level in the CPB-PTCA-group was aproximately 200 pg/ml. In the PTCA-group occured only minimal changes. The Il-6 level was more as two times higher in the CPB-CABG-group compared with the CPB-PTCA-group. The correlation of IL-6 peak levels and duration of CPB was further stronger in CPB-supported PTCA (r=0,785) than in CPB-CABG (r=0,463). Those datas indicate that the influence of the surgical trauma for the IL-6 release is stronger as the influence of the CPB. The prolonged duration of the CPB may contribute to the development of a systemic inflammatory response syndrome (SIRS). Reduction of bypass duration or elimination of CPB may further reduce the risk of SIRS. But regarding the results of this dissertation an reduction of the risk of SIRS on the same degree is to exspect from new operation methods like minimally invasive coronary bypass suegery with reduction of the surgical trauma |