Effects of aminophylline on cytokines and pulmonary function in patients undergoing valve replacement.

OBJECTIVE This study is to evaluate the effects of aminophylline on systemic inflammatory response after cardiopulmonary bypass in patients undergoing valve replacement. METHODS Thirty patients undergoing elective valve replacement were randomized to receive either aminophylline treatment (aminophylline, n = 15) or no aminophylline (control, n = 15). Administration of aminophylline (5 mg/kg) was injected intravenously after induction of anesthesia and maintained with 0.5 mg/kg per h until the end of cardiopulmonary bypass. Perioperative cytokines (interleukin-8 and interleukin-10, tumor necrosis factor-alpha) and respiratory function, blood neutrophil count ratio of right atrium to that of left atrium, plasma malondialdehyde were measured during the experiment. RESULTS Interleukin-8 and tumor necrosis factor-alpha levels after cardiopulmonary bypass were significantly lower in the aminophylline group than that in the control group (P < 0.05, for each group), and interleukin-10 level in aminophylline group was significantly higher than in control (P = 0.001). The respiratory index was greater in the control than in aminophylline group (P < 0.05). Neutrophil count ratio of right atrium blood to left atrium blood and plasma malondialdehyde level in aminophylline group were much lower (P = 0.02 and 0.001, respectively) than in the control 30 min after aortic declamping. Compared with control group, the duration of ventilation and intensive care unit stays were shorter in aminophylline group (P = 0.032 and 0.013, respectively). CONCLUSIONS Intraoperative administration of aminophylline had anti-inflammatory effect and improved pulmonary oxygenation in patients undergoing valve replacement.