Document Detail


Changes in cysteinyl leukotrienes during and after cardiac surgery with cardiopulmonary bypass in patients with and without chronic obstructive pulmonary disease.
MedLine Citation:
PMID:  21377695     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Pulmonary function frequently deteriorates after cardiopulmonary bypass (CPB). Chronic obstructive pulmonary disease (COPD) increases risk of respiratory complications after CPB. Cysteinyl leukotrienes are important mediators of respiratory dysfunction. Their role during cardiac surgery and its lung complications is incompletely understood. We studied whether production of cysteinyl leukotrienes changes during and after cardiac surgery with CPB and differs between patients with and without COPD.
METHODS: Patients with (n = 9) and without (n = 10) moderate-to-severe COPD undergoing cardiac surgery with CPB were prospectively included. Plasma and urinary cysteinyl leukotriene and leukotriene B(4) concentrations were measured by enzyme-linked immunosorbent assay after anesthesia induction, at end of CPB, after CPB, and 2 hours after intensive care unit admission. Gas exchange and respiratory mechanics were also assessed.
RESULTS: Patients with COPD had larger airway resistances after CPB and chest closure (P < .001), lower ratio of arterial Po(2) to inspired oxygen fraction at intensive care unit admission (215 ± 37 vs 328 ± 30 mm Hg, P < .05), and longer postoperative mechanical ventilation (13.7 ± 5.8 vs 6.8 ± 3.4 hours, P < .01). Urinary cysteinyl leukotriene concentrations increased with time in both groups (P < .01), but more in patients with than without COPD (P < .05). Plasma cysteinyl leukotriene concentrations increased significantly between baseline and intensive care unit admission in patients with but not without COPD (P < .01). Concentrations of leukotriene B(4) in plasma and urine did not increase significantly with time and were not different between groups.
CONCLUSIONS: Release of cysteinyl leukotrienes increases during cardiac surgery with CPB and is larger in patients with than without COPD. This may be related to higher lung and airway production of cysteinyl leukotrienes and neutrophil activation in patients with COPD.
Authors:
Nicolas de Prost; Claudine El-Karak; Maria Avila; Fumito Ichinose; Marcos F Vidal Melo
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2011-03-05
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  141     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-05-20     Completed Date:  2011-07-25     Revised Date:  2012-02-14    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1496-502.e3     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.
Affiliation:
Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, MA 02114, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Analysis of Variance
Biological Markers / blood,  urine
Boston
Cardiac Surgical Procedures* / adverse effects
Cardiopulmonary Bypass* / adverse effects
Chi-Square Distribution
Cysteine* / blood,  urine
Enzyme-Linked Immunosorbent Assay
Heart Diseases / immunology,  physiopathology,  surgery*
Humans
Inflammation Mediators* / blood,  urine
Leukotriene B4 / blood,  urine
Leukotrienes* / blood,  urine
Lung / physiopathology
Middle Aged
Neutrophil Activation
Prospective Studies
Pulmonary Disease, Chronic Obstructive / immunology*,  physiopathology
Pulmonary Gas Exchange
Respiration, Artificial
Respiratory Mechanics
Severity of Illness Index
Time Factors
Treatment Outcome
Grant Support
ID/Acronym/Agency:
R01 HL101930-03/HL/NHLBI NIH HHS; R01HL101930/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Inflammation Mediators; 0/Leukotrienes; 0/cysteinyl-leukotriene; 52-90-4/Cysteine; 71160-24-2/Leukotriene B4

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