体外循环引起全身炎症反应，可能导致术后血流动力学不稳定和终末器官功能障碍。本研究旨在探讨微创体外循环（MiECC）与传统体外循环（CECC）相比对全身炎症反应的影响。接受冠状动脉旁路移植术的患者被随机分为MiECC（n = 30）和CECC（n = 30） ）。主要终点是肿瘤坏死因子-α。次要终点是炎症的其他生化标志物（IL1β、IL6和IL8、C反应蛋白、白细胞）以及组织灌注不足和组织损伤的标志物（乳酸脱氢酶、乳酸和肌酸激酶-MB）。此外，我们还记录了全身炎症反应综合征、血流动力学不稳定、心房颤动、呼吸功能障碍和感染的体征。接受 MiECC 治疗的患者在体外循环期间和体外循环后早期的肿瘤坏死因子-α 水平显着低于 CECC（中位数：MiECC） 3.4 pg/mL；CI 2.2-4.5 对比 CECC 4.6 pg/mL；CI 3.4-5.6；p = 0.01)。肌酸激酶-MB 和乳酸脱氢酶水平较低表明组织损伤较少。然而，我们没有检测到任何其他炎症标志物、组织损伤或任何临床结果的显着差异。与 CECC 相比，MiECC 后 TNF-α 水平较低可能反映炎症反应减少，尽管其他炎症生化标志物相当。我们的结果表明，与 CECC 相比，MiECC 具有更好的终末器官保护作用。本研究中与全身炎症反应相关的临床参数具有可比性。NCT03216720.© 2024。作者。

Extracorporeal circulation causes a systemic inflammatory response, that may cause postoperative haemodynamic instability and end-organ dysfunction. This study aimed to investigate the impact of minimal invasive extracorporeal circulation (MiECC) on the systemic inflammatory response compared with conventional extracorporeal circulation (CECC).Patients undergoing coronary artery bypass grafting were randomized to MiECC (n = 30) and CECC (n = 30). Primary endpoint was tumor necrosis factor-α. Secondary endpoints were other biochemical markers of inflammation (IL1β, IL6 and IL8, C-reactive protein, leukocytes), and markers of inadequate tissue perfusion and tissue damage (lactate dehydrogenase, lactate and creatine kinase-MB). In addition, we registered signs of systemic inflammatory response syndrome, haemodynamic instability, atrial fibrillation, respiratory dysfunction, and infection.Patients treated with MiECC showed significantly lower levels of tumor necrosis factor-α than CECC during and early after extracorporeal circulation (median: MiECC 3.4 pg/mL; CI 2.2-4.5 vs. CECC 4.6 pg/mL; CI 3.4-5.6; p = 0.01). Lower levels of creatine kinase-MB and lactate dehydrogenase suggested less tissue damage. However, we detected no other significant differences in any other markers of inflammation, tissue damage or in any of the clinical outcomes.Lower levels of TNF-α after MiECC compared with CECC may reflect reduced inflammatory response, although other biochemical markers of inflammation were comparable. Our results suggest better end-organ protection with MiECC compared with CECC. Clinical parameters related to systemic inflammatory response were comparable in this study.NCT03216720.© 2024. The Author(s).