title: The impact of prostanoids on pulmonary gas exchange during abdominal surgery with mesenteric traction.
abstract: We investigated the effect of intravenous (iv) ibuprofen on prostanoid release and on pulmonary gas exchange after abdominal mesenteric traction (MT) during either abdominal aortic surgery or pancreas resection. In a prospective, randomized, double-blind study, 400 mg ibuprofen (pancreas n = 13, aorta n = 13) or a placebo (pancreas n = 13, aorta n = 13) was administered iv before skin incision. MT was applied uniformly. The prostanoid plasma concentrations, venous admixture (Q(va)/Q(t)), and PaO2/FIO2 ratio were determined at baseline (before MT) and 5, 15, 45, and 90 min after MT. Patients who underwent aortic surgery were older and exhibited a lower preoperative PaO2 than those who underwent pancreas resection. Placebo-treated patients revealed a 30-fold peak increase in 6-keto-prostaglandin F1alpha (stable metabolite of prostacyclin) levels after intentional MT during aortic as well as pancreatic operations. This response was accompanied by an increase in Q(va)/Q(t) (ibuprofen: pancreas 7% +/- 1%, aorta 14% +/- 2%; placebo: pancreas 16% +/- 3%, aorta 26% +/- 3%/15 min after MT [mean +/- SEM, P < 0.05, placebo vs ibuprofen]), which resulted in decreased PaO2/ FIO2 ratio only in the aortic surgery patients (ibuprofen: 310 +/- 19; placebo: 237 +/- 24 15 min after MT, [mean +/- SEM, P < 0.05]). The authors conclude that ibuprofen-pretreated patients demonstrated almost constant prostanoid levels without changes in pulmonary gas exchange after MT.
authors.affiliation: Department of Anesthesiology, University Clinics Ulm (Donau), Germany.
authors.forename: A
authors.initials: A
authors.lastname: Brinkmann
authors.forename: W
authors.initials: W
authors.lastname: Seeling
authors.forename: C F
authors.initials: CF
authors.lastname: Wolf
authors.forename: E
authors.initials: E
authors.lastname: Kneitinger
authors.forename: F
authors.initials: F
authors.lastname: Vogeser
authors.forename: M
authors.initials: M
authors.lastname: Rockemann
authors.forename: U
authors.initials: U
authors.lastname: Brückner
authors.forename: P
authors.initials: P
authors.lastname: Radermacher
authors.forename: M
authors.initials: M
authors.lastname: Büchler
authors.forename: M
authors.initials: M
authors.lastname: Georgieff
mesh_terms: D015121:6-Ketoprostaglandin F1 alpha / Q000097:blood / Q000378:metabolism; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D001012:Aorta, Abdominal / Q000601:surgery*; D016861:Cyclooxygenase Inhibitors / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D015232:Dinoprostone / Q000097:blood / Q000378:metabolism; D004311:Double-Blind Method; D011464:Epoprostenol / Q000097:blood / Q000378:metabolism; D005260:Female; D006801:Humans; D007052:Ibuprofen / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D007275:Injections, Intravenous; D007430:Intraoperative Care; D008297:Male; D008643:Mesentery / Q000473:pathology*; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D010180:Pancreatectomy; D010919:Placebos; D011446:Prospective Studies; D011453:Prostaglandins / Q000097:blood / Q000378:metabolism*; D011659:Pulmonary Gas Exchange / Q000187:drug effects*; D011667:Pulmonary Veins; D013929:Thromboxane B2 / Q000097:blood / Q000378:metabolism; D014143:Traction
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D016861:Cyclooxygenase Inhibitors; D010919:Placebos; D011453:Prostaglandins; D013929:Thromboxane B2; D015121:6-Ketoprostaglandin F1 alpha; D011464:Epoprostenol; D015232:Dinoprostone; D010100:Oxygen; D007052:Ibuprofen