[Procalcitonin after extracorporeal circulation. Synthesis in the hepatosplanchnic region].
Procalcitonin (PCT) is an inflammatory peptide of still unknown origin. In this study we investigated a potential source for circulating PCT in patients undergoing coronary artery bypass grafting.


METHODS
To determine PCT concentrations, arterial, liver-venous and mixed-venous blood samples were collected time matched perioperatively in 20 patients scheduled for cardiac surgery using cardiopulmonary bypass (CPB).


RESULTS
PCT concentrations significantly increased 4 hours postoperatively compared to baseline values (0.74 +/- 0.45 vs. 0.16 +/- 0.04 ng/ml). The highest concentrations were measured 18 hours postoperatively (1.44 +/- 1.01 ng/ml). PCT concentrations in liver venous samples were significantly higher (1.67 +/- 1.29 ng/ml) than in time matched collected arterial samples (1.44 +/- 1.01 ng/ml).


CONCLUSIONS
These results provide evidence, that hepatosplanchnicus is a source for PCT synthesis in patients following CPB. The mechanism of PCT induction remains unclear. A loss of gut mucosal barrier function with translocation of endotoxins and the inflammatory response with release of cytokines following cardiopulmonary bypass has to be discussed.
Klinik für Anästhesiologie und Intensivmedizin, Universitätskliniken des Saarlandes, Homburg/Saar. aimsil@med-rz.uni-sb.de
M
M
Silomon
F
F
Bach
D
D
Ecker
T
T
Graeter
U
U
Grundmann
R
R
Larsen
D002116:Calcitonin / Q000096:biosynthesis* / Q000097:blood; D015740:Calcitonin Gene-Related Peptide; D001026:Coronary Artery Bypass; D016207:Cytokines / Q000378:metabolism; D005112:Extracorporeal Circulation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008099:Liver / Q000098:blood supply / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011498:Protein Precursors / Q000096:biosynthesis* / Q000097:blood; D013152:Splanchnic Circulation / Q000502:physiology*
C000606589:CALCA protein, human; D016207:Cytokines; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide
Procalcitonin nach extrakorporaler Zirkulation. Synthese im Hepatosplanchnikusgebiet?