Predictive value of IL-18 and SC5b-9 for neurocognitive dysfunction after cardiopulmonary bypass

Br J Anaesth. 2007 Mar;98(3):317-22. doi: 10.1093/bja/ael366. Epub 2007 Jan 16.

Abstract

Background: Neurological injury after cardiopulmonary bypass (CPB) continues to be a major problem after cardiac surgery. The aim of this study was to investigate the predictive value of Interleukin-18 (IL-18) and SC5b-9 as biochemical markers of neurocognitive dysfunction after cardiac surgery.

Methods: A total of 30 patients undergoing elective cardiac surgery using CPB were recruited. Blood samples were obtained for IL-18 and SC5b-9 concentrations before induction, 24, 48, 72, 96 and 120 h post-CPB and 6 weeks after operation. In addition, patients underwent a standard battery of neuropsychometric tests before operation and at day 5 and 6 weeks after operation.

Results: Serum concentration of IL-18, but not SC5b-9, was significantly different between patients with and without neurocognitive dysfunction; serum IL-18 concentration significantly increased in patients with neurocognitive dysfunction (P = 0.018). Neurological outcome was significantly dependent on peak difference in IL-18 concentration at day 5 (P = 0.033), but not on peak difference in SC5b-9 concentration (P = 0.16). Eight patients had neurocognitive dysfunction at day 5 and three had neurocognitive dysfunction at 6 weeks. In a very small number of patients, no significant association was demonstrated between IL-18 or SC5b-9 concentrations and neurocognitive dysfunction at 6 weeks.

Conclusions: IL-18 has the potential as a useful marker of neurological dysfunction, requiring further investigation.

Publication types

  • Evaluation Study

MeSH terms

  • Aged
  • Biomarkers / blood
  • Cardiac Surgical Procedures
  • Cardiopulmonary Bypass / adverse effects*
  • Cognition Disorders / blood
  • Cognition Disorders / diagnosis*
  • Cognition Disorders / etiology
  • Complement Membrane Attack Complex
  • Complement System Proteins / metabolism*
  • Female
  • Humans
  • Interleukin-18 / blood*
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Postoperative Period
  • Predictive Value of Tests

Substances

  • Biomarkers
  • Complement Membrane Attack Complex
  • Interleukin-18
  • SC5b-9 protein complex
  • Complement System Proteins