| Changes in cysteinyl leukotrienes during and after cardiac surgery with cardiopulmonary bypass in patients with and without chronic obstructive pulmonary disease. | |
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MedLine Citation:
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PMID: 21377695 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Nicolas de Prost; Claudine El-Karak; Maria Avila; Fumito Ichinose; Marcos F Vidal Melo |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2011-03-05 |
Journal Detail:
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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:
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Created Date: 2011-05-20 Completed Date: 2011-07-25 Revised Date: 2012-02-14 |
Medline Journal Info:
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Nlm Unique ID: 0376343 Medline TA: J Thorac Cardiovasc Surg Country: United States |
Other Details:
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Languages: eng Pagination: 1496-502.e3 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2011 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved. |
Affiliation:
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Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, MA 02114, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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R01 HL101930-03/HL/NHLBI NIH HHS; R01HL101930/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 0/Inflammation Mediators; 0/Leukotrienes; 0/cysteinyl-leukotriene; 52-90-4/Cysteine; 71160-24-2/Leukotriene B4 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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