Body mass index is negatively correlated with respiratory muscle weakness and interleukin-6 production after coronary artery bypass grafting

J Crit Care. 2010 Mar;25(1):172.e1-8. doi: 10.1016/j.jcrc.2009.05.012. Epub 2009 Aug 13.

Abstract

Purpose: The present study was performed to clarify the relationships between body mass index (BMI), interleukin-6 (IL-6) production, and respiratory muscle weakness in patients undergoing coronary artery bypass grafting (CABG).

Materials and methods: The correlations among BMI, changes in maximum inspiratory and expiratory pressure (DeltaMIP, DeltaMEP) on postoperative days (POD) 1 and 7, postoperative IL-6, and rapid turnover proteins (retinol-binding protein, prealbumin, and transferrin) on POD1 were assessed in 154 consecutive patients undergoing elective CABG. The patients were divided into quartiles of BMI, Q1 (BMI, <20.8 kg/m(2)) to Q4 (BMI, > or =25.25 kg/m(2)), and compared among groups.

Results: There were significant correlations between DeltaMIP and BMI (POD1, r = -0.369; POD7, r = -0.285) and IL-6 (POD1, r = 0.423; POD7, r = 0.431), and between DeltaMEP and BMI (POD1, r = -0.252; POD7, r = -0.228) and IL-6 (POD1, r = 0.252; POD7, r = 0.384). Interleukin-6 showed a significant negative correlation with BMI (r = -0.374) and retinol-binding protein (r = -0.382). Interleukin-6 was highest in Q1 and lowest in Q4. Higher BMI indicated greater respiratory muscle strength than lower BMI.

Conclusions: Preoperative BMI is correlated with respiratory muscle strength and cytokine production after CABG. The findings of this study suggest that BMI may be a valuable predictor for respiratory management in CABG patients.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Body Mass Index*
  • Coronary Artery Bypass*
  • Female
  • Humans
  • Interleukin-6 / biosynthesis*
  • Interleukin-6 / blood
  • Male
  • Middle Aged
  • Muscle Weakness / etiology
  • Muscle Weakness / physiopathology*
  • Postoperative Complications* / etiology
  • Predictive Value of Tests
  • Respiratory Function Tests
  • Respiratory Mechanics
  • Respiratory Muscles / physiopathology*
  • Retinol-Binding Proteins / analysis

Substances

  • Interleukin-6
  • Retinol-Binding Proteins