Effects of anesthetic choice on inflammatory response in cardiac surgery

Cardiac surgery is associated with the development of a systemic inflammatory response. The cytokine response in cardiac surgery patients is well explained and is dominated by the pro-inflammatory cytokines tumour necrosis factor (TNF-α), interleukin-6 (IL-6), interleukin-8 (IL-8), and the antiinflammatory cytokine interleukin-10 (IL-10). The release of these cytokines has been related to the development of complications after cardiopulmonary bypass (CPB). In addition to many factors, choice of anesthetic agents affects immune response in cardiac surgery. This article summarizes recently published literature concerning inflammatory cytokines associated with cardiopulmonary bypass, use of anesthetic management techniques and their effects on inflammatory response in cardiac surgery.