Studies have demonstrated that
systemic inflammatory response syndrome (SIRS) remains one of the major causes of
cardiopulmonary bypass (CPB)-associated organ injury during pediatric cardiac surgery. The purpose of this investigation was to compare the effectiveness of
methylprednisolone (MP) and zero-balance ultrafiltration (ZBUF) on SIRS during pediatric CPB. Thirty infants undergoing open-heart surgeries were randomized to receive either MP in the priming
solution (group M, n = 15) or ZBUF during CPB (group Z, n = 15). All the patients survived. Plasma levels of
tumor necrosis factor-alpha (
TNF-alpha),
interleukin-6 (IL-6),
interleukin-8 (IL-8), and
interleukin-10 (IL-10) were measured before CPB (T1), 5 min after the start of CPB (T2), at the termination of CPB (T3), the fourth hour (T4), and the eighth hour (T5) postoperatively. The results showed that the plasma concentrations of
TNF-alpha in the Z group were significantly less than those in the M group at T4 and T5 (P < 0.05), and the plasma concentrations of
IL-6 were significantly less than those in the M group at T4 (P < 0.05); the plasma concentrations of
IL-8 in the Z group were significantly less than those in the M group at T5 (P < 0.05). There was no difference between two groups on the plasma concentrations of
IL-10. The duration of postoperative
mechanical ventilation was (9.6 +/- 0.8 h) in the M group and (7.8 +/- 0.4 h) in the Z group (P < 0.05). This study showed that application of ZBUF is more effective to decrease the level of inflammatory mediators including
TNF-alpha,
IL-6, and
IL-8 than administration of MP after pediatric CPB.