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BJA Advance Access originally published online on January 16, 2007
British Journal of Anaesthesia 2007 98(3):317-322; doi:10.1093/bja/ael366
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

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

R. A. Kumar*, C. Cann, J. E. Hall, P. S. Sudheer and A. R. Wilkes

Department of Anaesthetics and Intensive Care Medicine, Wales College of Medicine, Cardiff University, Heath Park, Cardiff CF14 4XN, UK

* Corresponding author: Department of Anaesthetics and Intensive Care Medicine, Wales College of Medicine, Cardiff University, Heath Park, Cardiff CF14 4XN, UK. E-mail: arunkumar{at}btinternet.com

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.

Keywords: blood, IL-18; blood, SC5b-9; brain, injury; heart, cardiopulmonary bypass; polypeptides, IL-18; polypeptides, SC5b-9


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R. P. Alston, R. A. Kumar, C. Cann, J. Hall, P. Sudheer, and A. Wilkes
IL-18 and SC5b-9 for predicting neurocognitive dysfunction after cardiopulmonary bypass
Br. J. Anaesth., September 1, 2007; 99(3): 444 - 445.
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The perils of dichotomisation
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British Journal of Anaesthesia, 11 May 2007 [Full text]
IL-18 and SC5b-9 for predicting neurocognitive dysfunction after cardiopulmonary bypass
Rajappan-Nair A Kumar, et al.
British Journal of Anaesthesia, 6 Jun 2007 [Full text]

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