| Autor: |
Rothenburger, Markus, Soeparwata, Rasjid, Deng, Mario C., Schmid, Christof, Berendes, Elmar, Tjan, Tonny D.T., Wilhelm, Markus J., Erren, Michael, Böcker, Dirk, Scheld, Hans H. |
| Zdroj: |
Shock; January 2001, Vol. 16 Issue: Supplement 1 p44-50, 7p |
| Abstrakt: |
Coronary artery bypass grafting CABG using cardiopulmonary bypass CPB can lead to a systemic inflammatory response syndrome with organ failure and increased morbidity and mortality. The mechanisms of these findings are still under discussion. We investigated whether antiendotoxin core antibodies, endotoxin, and proinflamma tory cytokines influence the clinical course after cardiac surgery. Seventyeight patients undergoing CABG using CPB were investigated. Antiendotoxin core antibodies, endotoxin, interleukin IL6, IL8, IL1 , and TNF were measured 24 h preoperatively and up to 72 h postoperatively. Patients with a postoperative mechanical ventilation time below 24 h n 65 Group A were compared to patients with prolonged respirator therapy >24 h n 13 Group B. Preoperative antibody levels were significantly lower in Group B P< 0.001. In this group, antibody levels remained decreased during the observation period P< 0.001. Endotoxin significantly increased 30' postoperatively in both groups P< 0.002. The increase in Group B was 3fold higher P< 0.001. IL8 increased postoperatively in both groups, peaking 3 h after surgery P< 0.001. In Group B, the IL8 release was significantly higher than in Group A P< 0.001. IL6 significantly increased in both groups, reaching its maximum 24 h postoperatively P< 0.001. No differences between groups were observed. No significant changes of IL1 and TNF were observed. We conclude that antiendotoxin core antibodies may be predictive of adverse outcome after cardiac surgery. The imbalance between antibodies and endotoxin results in an exaggerated increase in endotoxin and IL8 with an impact on clinical outcome. |
| Databáze: |
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