title: Role of thromboxane and leukotriene B4 in patients with acute respiratory distress syndrome after oesophagectomy.
abstract: We have studied prospectively the clinical course and serum concentrations of thromboxane B2 (TxB2) and leukotriene B4 (LTB4) in patients developing adult respiratory distress syndrome (ARDS) after oesophagectomy. The clinical course was assessed according to a validated ARDS score, and intra- and postoperative measurements of TxB2 and LTB4 in pre- and post-pulmonary blood were performed in 18 patients undergoing oesophagectomy for oesophageal carcinoma and 11 control patients undergoing thoracotomy and pulmonary resection. Six of 18 patients undergoing oesophagectomy, but no control patient, developed ARDS. The ARDS score was highest on day 8 after operation. Only patients with ARDS had a significant postoperative increase in post-pulmonary, but not pre-pulmonary, TxB2 concentrations (P < 0.05 vs patients without ARDS). This study provides evidence that TxA2, originating from the lungs, was associated with the development of ARDS after oesophageal resection. In view of the high incidence of ARDS after oesophagectomy (10-30%), prophylactic treatment of patients undergoing oesophageal resection with clinically applicable thromboxane synthetase inhibitors may be warranted.
authors.affiliation: Department of Visceral and Transplantation Surgery, University of Bern-Inselspital, Switzerland.
authors.forename: M K
authors.initials: MK
authors.lastname: Schilling
authors.forename: N
authors.initials: N
authors.lastname: Gassmann
authors.forename: G H
authors.initials: GH
authors.lastname: Sigurdsson
authors.forename: B
authors.initials: B
authors.lastname: Regli
authors.forename: C
authors.initials: C
authors.lastname: Stoupis
authors.forename: M
authors.initials: M
authors.lastname: Furrer
authors.forename: C
authors.initials: C
authors.lastname: Signer
authors.forename: C
authors.initials: C
authors.lastname: Redaelli
authors.forename: M W
authors.initials: MW
authors.lastname: Büchler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D004938:Esophageal Neoplasms / Q000097:blood / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007975:Leukotriene B4 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D012128:Respiratory Distress Syndrome / Q000097:blood* / Q000209:etiology; D012307:Risk Factors; D013929:Thromboxane B2 / Q000097:blood* / Q000502:physiology
chemical_list: D015415:Biomarkers; D007975:Leukotriene B4; D013929:Thromboxane B2