Document Detail

Extracorporeal circulation does not induce intra-alveolar release of Endothelin 1, but only a modest overproduction in pulmonary circulation.
MedLine Citation:
PMID:  10532204     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To investigate whether ECC may produce regional liberation of inflammatory mediators capable of inducing vascular effects and organ damage. EXPERIMENTAL DESIGN: Comparative study [corrected]. SETTING: Cardiac surgery department in a University hospital. PATIENTS: Fifteen patients undergoing coronary artery bypass grafting (CABG, group A) and ten patients operated for infrarenal abdominal aortic aneurysm (controls, group B) have been studied. MEASURES: Levels of Interleukin 1beta (IL1), Tumor Necrosis Factor alpha (TNF), Interleukin 6 (IL6), and Endothelin 1 (ET1) were measured in pulmonary capillary, arterial, and venous blood and in bronchoalveolar lavages (BAL) before, during and after extracorporeal circulation (ECC) or surgical intervention. RESULTS: TNF-alpha (never >35 pg/ml) and IL1beta (range 20-300 pg/ml) values did not change over time for both groups. IL6 concentrations in all samples of group A increased between five and twenty fold, during and after ECC (from 3-5 pg/ml up to 240 pg/ml, p<0.001). This trend was similar in controls after surgical stress. Endothelin 1 was always undetectable in the BAL fluid, with a modest, but significant increase in pulmonary capillary blood of group A, after ECC, (from 11+/-4 pg/ml to 18+/-5 pg/ml, p<0.001). This increment correlated well with the PVR increase, but was transient and after 24 hours, ET1 values returned to baseline levels. Mean values of ET1 increased also in controls, but not significantly. CONCLUSIONS: ECC may induce ET1 liberation in pulmonary circulation with transient pulmonary vasoconstriction, but wihout intra-alveolar release, or lung damage. Augmented concentrations of IL6 probably express a response to surgical procedure rather than an effect exclusively related to ECC.
M Antonelli; C Letizia; L Tritapepe; G M Raponi; M C Ghezzi; A Menichetti; G Ruvolo; L Riccioni; R A Deblasi
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of cardiovascular surgery     Volume:  40     ISSN:  0021-9509     ISO Abbreviation:  J Cardiovasc Surg (Torino)     Publication Date:  1999 Aug 
Date Detail:
Created Date:  1999-10-28     Completed Date:  1999-10-28     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0066127     Medline TA:  J Cardiovasc Surg (Torino)     Country:  ITALY    
Other Details:
Languages:  eng     Pagination:  487-94     Citation Subset:  IM    
Department of Anesthesiology and Intensive Care, La Sapienza University, Rome, Italy.
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MeSH Terms
Aged, 80 and over
Aortic Aneurysm, Abdominal / blood,  surgery*
Bronchoalveolar Lavage Fluid / chemistry
Coronary Artery Bypass*
Coronary Disease / blood,  surgery*
Endothelin-1 / blood*
Endothelium, Vascular / metabolism
Extracorporeal Circulation*
Interleukin-1 / blood
Middle Aged
Pulmonary Alveoli / blood supply*
Pulmonary Circulation / physiology*
Reference Values
Tumor Necrosis Factor-alpha / metabolism
Reg. No./Substance:
0/Endothelin-1; 0/Interleukin-1; 0/Tumor Necrosis Factor-alpha
Erratum In:
J Cardiovasc Surg (Torino) 1999 Dec;40(6):927

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