Document Detail


Production of nitric oxide during surgery involving cardiopulmonary bypass.
MedLine Citation:
PMID:  9468164     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Surgery involving cardiopulmonary bypass induces an inflammatory response due to the contact of blood with the extracorporeal circuit. In some patients, this inflammatory response leads to multiple organ failure and death. Inflammatory states may increase the production of nitric oxide, either by increasing the activity of constitutive enzyme systems or by inducing of inflammation-specific systems. We hypothesized that surgery involving cardiopulmonary bypass would increase the production of nitric oxide in association with the inflammatory response. DESIGN: Prospective, single center, observational study. SETTING: University-affiliated, tertiary referral cardiothoracic center. PATIENTS: Eleven adult patients undergoing routine myocardial revascularization. INTERVENTIONS: Surgery for myocardial revascularization. MEASUREMENTS AND MAIN RESULTS: Observations were made after induction of anesthesia, before bypass, after completion of the bypass, and on return to the recovery area. Parameters measured included hemodynamics, exhaled nitric oxide concentrations, plasma nitrate/nitrite concentration, plasma and bronchoalveolar lavage myeloperoxidase concentrations, and protein carbonyl conversion. All patients survived surgery. Oxygenation index fell significantly after bypass. Plasma myeloperoxidase increased significantly during the study period. Plasma carbonyl conversion also increased, although not significantly. Plasma nitrate/nitrite and airway nitric oxide concentrations did not change through the course of the study. CONCLUSION: Surgery involving cardiopulmonary bypass induced a demonstrable inflammatory response, but this response was not associated with increased nitric oxide production.
Authors:
S J Brett; G J Quinlan; J Mitchell; J R Pepper; T W Evans
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Critical care medicine     Volume:  26     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:  1998 Feb 
Date Detail:
Created Date:  1998-02-26     Completed Date:  1998-02-26     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  272-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Critical Care, National Heart & Lung Institute, Royal Brompton Hospital, London, UK.
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MeSH Terms
Descriptor/Qualifier:
Aged
Breath Tests / methods
Bronchoalveolar Lavage Fluid / chemistry
Cardiopulmonary Bypass* / methods
Hemodynamics
Humans
Intraoperative Period
Male
Middle Aged
Neutrophil Activation
Nitric Oxide / analysis,  biosynthesis*
Postoperative Complications / metabolism,  physiopathology
Prospective Studies
Chemical
Reg. No./Substance:
10102-43-9/Nitric Oxide
Comments/Corrections
Comment In:
Crit Care Med. 1998 Feb;26(2):208-9   [PMID:  9468151 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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