Increased concentrations of cytokines and adhesion molecules in patients after repair of abdominal aortic aneurysm.
OBJECTIVE
To evaluate the association between inflammatory mediators and clinical outcome in patients after repair of abdominal aortic aneurysms.


METHODS
Prospective study.


METHODS
University hospital, The Netherlands.


METHODS
30 Consecutive patients who had undergone elective or acute repair of abdominal aortic aneurysms.


METHODS
Plasma concentrations of the cytokines tumour necrosis factor (TNF), interleukin-6 (IL-6) and interleukin-8 (IL-8) as well as soluble TNF receptors and the soluble (s) adhesion molecules E-selectin and intercellular adhesion molecule 1 (ICAM-1) were measured and correlated with the degree of systemic hypotension (shock: hypotension more than 15 minutes) and clinical outcome.


RESULTS
Peak plasma concentrations of TNF and IL-6 were significantly higher in shocked patients (p < 0.005 and p < 0.0005, respectively) and those who died (both p < 0.01), whereas concentrations of IL-8 increased only when shock complicated rupture of the aneurysm (p < 0.01). Increases in the concentrations of TNF receptors reflected impaired renal function. In contrast to sE-selectin concentrations, peak sICAM-1 concentrations were significantly higher in shocked patients (p < 0.01) and those that died (p < 0.01).


CONCLUSIONS
These results strongly suggest that increased concentrations of sICAM-1 and IL-6 reflect the inflammatory response induced by ischaemia after repair of an abdominal aortic aneurysm, and indicate that the postoperative course is likely to be complicated.
Froon
A H
AH
Department of Surgery, University Hospital Maastricht, The Netherlands.
Greve
J W
JW
Van der Linden
C J
CJ
Buurman
W A
WA
D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000097:blood* / Q000401:mortality / Q000601:surgery*; D001019:Aortic Rupture / Q000097:blood / Q000401:mortality / Q000601:surgery; D016022:Case-Control Studies; D016207:Cytokines / Q000097:blood*; D019040:E-Selectin / Q000097:blood*; D005260:Female; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood*; D008297:Male; D012771:Shock, Hemorrhagic / Q000097:blood* / Q000401:mortality; D012773:Shock, Surgical / Q000097:blood* / Q000401:mortality; D015996:Survival Rate; D013997:Time Factors
D016207:Cytokines; D019040:E-Selectin; D018799:Intercellular Adhesion Molecule-1