Cytokine and fibrinogen response in patients undergoing open abdominal aortic aneurysm surgery.
OBJECTIVE
To assess whether open abdominal aortic aneurysm (AAA) surgery influences cytokines and fibrinogen.


METHODS
Twenty-three consecutive patients operated on for AAA were compared to 11 operated controls and 20 age-matched controls. Cubital blood was sampled pre-, intra- and postoperatively and femoral blood also sampled intraoperatively.


RESULTS
Preoperatively, interleukin (Il)-6 was elevated in AAA patients. During aortic clamping, Il-6, Il-10 and monocyte chemoattractant protein-1 (MCP-1) increased significantly (p < 0.001, p < 0.01 and p < 0.05 respectively) while soluble interleukin-2 receptor (sIl-2R) and fibrinogen decreased significantly (p < 0.001 for both). After aortic declamping, Il-6, Il-10 and MCP-1 had further significant increases compared with levels during aortic clamping while sIl-2R had a further non-significant and fibrinogen a significant decrease (p < 0.05 in cubital and p < 0.001 in femoral blood). One week postoperatively Il-6, Il-10 and MCP-1 had all decreased but were still significantly elevated compared with baseline values while sIl-2R and fibrinogen showed an increase in comparison with baseline (p < 0.001 for both). Intraoperative levels of Il-6 and Il-10 showed a significant co-variation with the magnitude of operative trauma.


CONCLUSIONS
These data indicate that open AAA surgery induces a profound inflammatory and coagulative response which persists at one week postoperatively.
Holmberg
A
A
Department of Surgery, University Hospital Uppsala, Sweden.
Bergqvist
D
D
Westman
B
B
Siegbahn
A
A
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000276:immunology / Q000601:surgery*; D015415:Biomarkers / Q000097:blood; D016207:Cytokines / Q000097:blood*; D005340:Fibrinogen / Q000378:metabolism*; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D015427:Reperfusion Injury / Q000097:blood / Q000175:diagnosis; D018746:Systemic Inflammatory Response Syndrome / Q000175:diagnosis* / Q000276:immunology
D015415:Biomarkers; D016207:Cytokines; D005340:Fibrinogen