Systemic Inflammatory Response and Clinical Outcomes in Cardiac Surgery with Cardiopulmonary Bypass: A Prospective Observational Study
Keywords:
Cardiopulmonary Bypass; Systemic Inflammatory Response; Interleukin-6; Neutrophil/Lymphocyte Ratio; Vasoplegia.Abstract
Introduction: Cardiopulmonary bypass triggers a systemic inflammatory response that can lead to organ dysfunction and adverse outcomes after cardiac surgery. Characterizing this response in local cohorts is crucial for risk stratification.
Objective: To expose the kinetics of inflammatory markers and clinical outcomes in a prospective cohort of on-pump cardiac surgery in “Hermanos Ameijeiras” hospital, contrasting the findings with international literature.
Methods: A single-center, prospective, observational study was conducted in 23 adult patients undergoing elective on-pump cardiac surgery. Demographic variables, comorbidities, intraoperative parameters, serial inflammatory biomarkers (interleukin-6, complete blood count, and derived indices), and postoperative complications were collected.
Results: The median serum Interleukin-6 peaked at 24 hours post-surgery (246.97 pg/ml; IQR 106.73-489.67). Significant leukocytosis and neutrophilia with relative lymphopenia were observed, resulting in a progressive elevation of the Neutrophil/Lymphocyte Ratio, reaching a median of 7.01 (IQR 5.30-10.06) at 48 hours. Postoperative complications were notable: low cardiac output syndrome (17.4%), vasoplegic shock (8.7 %), and an overall mortality of 21.7 % (5/23). ICU and hospital stays were 2 (IQR 2-4) and 33.5 days (IQR 17-47.25), respectively.
Conclusions: On-pump cardiac surgery in this cohort is associated with a high-intensity systemic inflammatory response, characterized by an early peak in IL-6 and a marked elevation of the NLR. This profile is linked to significant morbidity and mortality. Monitoring these biomarkers in the first 48 hours emerges as a potential tool for early risk stratification.
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Copyright (c) 2026 Alberto Hernández González, Raúl de Jesús Delgado Serrano, Luis Alberto Morales Magón, Calixto Luaces Fernández, Roxana Castillo López, Zuleica del Carmen Gali Navarro
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