Endotoxaemia and postoperative hypermetabolism in coronary artery bypass surgery: the role of ketanserin.
In a randomized, double-blind clinical study in 29 patients undergoing elective coronary artery surgery, we assessed the role of ketanserin, an inhibitor of serotonin-induced vasoconstriction and weak alpha 1 sympathetic blocker, in reducing endotoxaemia and postoperative hypermetabolism. Male patients without major organ dysfunction were allocated randomly to receive either ketanserin or placebo. Hypermetabolism was defined as an increase in oxygen consumption in the early postoperative hours (delta Vo2). Circulating endotoxin (P = 0.04) and postoperative delta Vo2 (P = 0.03) were lower in the ketanserin patients. Endotoxaemia was associated also with low vascular filling. From these preliminary results we conclude that treatment with ketanserin during cardiac surgery may reduce but not abolish endotoxaemia and postoperative hypermetabolism.
Oudemans-van Straaten
H M
HM
Department of Intensive Care, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
Jansen
P G
PG
Velthuis
H
H
Stoutenbeek
C P
CP
Zandstra
D F
DF
Deventer
S J
SJ
Sturk
A
A
Wildevuur
C R
CR
Eijsman
L
L
D000368:Aged; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D004311:Double-Blind Method; D004731:Endotoxins / Q000097:blood*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007650:Ketanserin / Q000627:therapeutic use*; D008297:Male; D008659:Metabolic Diseases / Q000209:etiology / Q000517:prevention & control; D008875:Middle Aged; D010101:Oxygen Consumption / Q000187:drug effects*; D011184:Postoperative Period; D012702:Serotonin Antagonists / Q000627:therapeutic use*
D004731:Endotoxins; D012702:Serotonin Antagonists; D007650:Ketanserin