[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.
Silomon
M
M
Klinik für Anästhesiologie und Intensivmedizin, Universitätskliniken des Saarlandes, Homburg/Saar. aimsil@med-rz.uni-sb.de
Bach
F
F
Ecker
D
D
Graeter
T
T
Grundmann
U
U
Larsen
R
R
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?