Effect of Anesthetics on CD39 and CD73 After Open-heart Surgery

After obtaining permission of the Institutional Review Board of Konkuk University Medical Center, Seoul, South Korea , patients scheduled to undergo elective cardiac surgery under cardiopulmonary bypass (CPB) after signed written informed consent agreements and prospectively participate in the present study.

All patients got a cardiac surgery under moderate hypothermic cardiopulmonary bypass (CPB) by one cardiac surgeon. Also, 6ml of blood and sample was obtained for total 5 times in consecutive order.

• Before operation (pre-CPB1)
• 15 minute after successful CPB weaning (post-CPB1)
• 3 hrs after CPB weaning (post-CPB2)
• 24 hrs after CPB weaning (post-CPB3)
• 48 hrs after CPB weaning (post-CPB4)

The following intraoperative exclusion criteria are applied:

• Emergency operation that could not obtain pre-CPB1 sample
• Patients who have infectious factor before operation
• Patients who have immunosuppressive agent for underlying disease before operation
• Patients who have history of cancer previously
• Patients who are younger than 19 years old

Using blood sample, authors examined as follows

• Flow cytometry for Th 17 and Th 1 cell.
• Immunocytochemistry for CD39, CD73.
• Assay for IL 1,6,10,17,IFN-γ, and TNF-α
• patient vital sign during operation
• other laboratory tests

Statistical analyses are conducted using SPSS 20.0 (SPSS Inc., Chicago, IL, USA). CD39 and CD73 are analysed used a Repeated Measures Analysis of Variance and their pairwise multiple comparisons are performed via the tukey method. The comparisons of the other continuous variables are performed by paired t or Wilcoxon Signed Rank tests. Data are expressed as mean ± SD (95% confidence interval. CI) or median (25%-75%), and number of the patients. A p value less than 0.05 is considered statistically significant.

Inclusion criteria

• patients scheduled to undergo elective cardiac surgery
• signed written informed consent agreements

Exclusion criteria

• Emergency operation that could not obtain pre-CPB1 sample
• Patients who have infectious factor before operation
• Patients who have immunosuppressive agent for underlying disease before operation
• Patients who have history of cancer previously
• Patients who are younger than 19 years old