We would like to mention the study of Geyik et al. about coronary bypass (CBP) period and systemic inflamatory response is very interesting and useful.1) As the authors stated, strong systemic inflammatory response takes place due to mediators caused by contact of blood and extracorporeal surface during CBP, myocardial ischemia reperfusion secondary to aortic cross-clamping (ACC), endotoxemia and operative trauma.2–4) It is obviously seen that CBP is the most important factor among these. Related to that, when the study of Geyik et al. is considered, there is a general standardization of perioperative data between two groups that are distinguished up to operation period. However, we claim that there shouldn’t be any difference also in between CBP periods and between ACC periods in order to have a reliable comparison in terms of systemic inflamatory response; because many studies revealed that systemic inflammatory response is increased by longer periods of CPB and ACC.3–5) In this point, we suggest that the study would be more valuable if the authors share these data with us.
Disclosure Statement
The authors declare that they have no conflict of interest.
References
- 1).Geyik S, Yiğiter R, Akçalı A, et al. The effect of circadian melatonin levels on inflammation and neurocognitive functions following coronary bypass surgery. Ann Thorac Cardiovasc Surg 2015; 20; 21: 466–73. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2).Paparella D, Yau TM, Young E. Cardiopulmonary bypass induced inflammation: pathophysiology and treatment. An update. Eur J Cardiothorac Surg 2002; 21: 232-44. [DOI] [PubMed] [Google Scholar]
- 3).Güvener M, Korun O, Demirtürk OS. Risk factors for systemic inflammatory response after congenital cardiac surgery. J Card Surg 2015; 30: 92-6. [DOI] [PubMed] [Google Scholar]
- 4).Murphy GJ, Angelini GD. Side effects of cardiopulmonary bypass: what is the reality? J Card Surg 2004; 19: 481-8. [DOI] [PubMed] [Google Scholar]
- 5).Hosgood SA, Shah K, Patel M, et al. The effect of prolonged of warm ischaemic injury on renal function in an experimental ex vivo normothermic perfusion system. J Transl Med 2015; 13: 207. [DOI] [PMC free article] [PubMed] [Google Scholar]