Systemic inflammatory response syndrome after on-pump cardiac surgery in emergency coronary artery bypass grafting: a retrospective trial

Abstract

INTRODUCTION: The frequency, spectrum and pathophysiological relationships of systemic inflammatory response syndrome in acute coronary artery bypass grafting is not fully understood. OBJECTIVE: To determine the clinical significance of systemic inflammatory response syndrome (SIRS) in emergency coronary artery bypass grafting (CABG) performed with cardiopulmonary bypass. MATERIALS AND METHODS: We examined 60 patients (38 men and 22 women, aged 65 ± 9 years) who underwent emergency CABG (3 ± 1 bypass), with cardiopulmonary bypass (CPB) (97 ± 47 min). We retrospectively studied clinical and laboratory data of the perioperative and early postoperative period from emergency and elective coronary bypass surgery. RESULTS: In urgently operated patients (n = 30) in the early postoperative period, a higher frequency (53.3 and 13.3 %; p = 0.0022) of the development of systemic manifestations of the inflammatory response (neutrophilic leukocytosis, fever, postperfusion vasoplegia), as well as respiratory complications (70 and 10 %; p < 0.001) was noted. A pathophysiological relationship was established between the manifestations of SIRS and respiratory dysfunction during emergency interventions. CONCLUSIONS: SIRS pathophysiologically associated with respiratory dysfunction is characteristic of emergency CABG. It is during emergency myocardial revascularization that the duration of cardiopulmonary bypass and myocardial ischemia (MI) are predictors of SIRS.