title: Activation of a neutrophil-derived inflammatory response in the airways during cardiopulmonary bypass.
abstract: Cardiopulmonary bypass (CPB) is believed to cause postoperative lung dysfunction. To more closely examine the inflammatory processes occurring in the airways during CPB, we serially measured inflammatory mediators, with the assistance of a new bronchoscopic microsample probe, in 11 patients undergoing repair of aortic arch aneurysms. Epithelial lining fluid (ELF) and arterial blood were sampled simultaneously after induction of anesthesia, at the time of pulmonary reperfusion, and at the end of surgery. A decrease in the PaO2/FiO2 ratio was observed at the end of surgery (P = 0.029). Although the ELF concentrations of interleukin (IL)-8, IL-6, and neutrophil elastase had increased significantly at the end of surgery (median = 23,200, 1818, and 12,900 microg/mL, respectively), they did not correlate with the degree of hypoxemia. Neutrophil elastase increased significantly at the time of pulmonary reperfusion, before IL-8 and IL-6, and independently of blood transfusions. At the end of surgery, IL-6 in ELF correlated with total blood transfusion volume (rho = 0.731, P = 0.011). These results indicate that a neutrophil-derived inflammatory response is activated in the airway in the early phase of CPB.
authors.forename: Toru
authors.initials: T
authors.lastname: Kotani
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Kotake
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Morisaki
authors.forename: Junzo
authors.initials: J
authors.lastname: Takeda
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Shimizu
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Ueda
authors.forename: Akitoshi
authors.initials: A
authors.lastname: Ishizaka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000209:etiology*; D015850:Interleukin-6 / Q000096:biosynthesis; D016209:Interleukin-8 / Q000096:biosynthesis; D019272:Leukocyte Elastase / Q000032:analysis; D008297:Male; D009504:Neutrophils / Q000502:physiology*
chemical_list: D015850:Interleukin-6; D016209:Interleukin-8; D019272:Leukocyte Elastase