A global assessment of the inflammatory response elicited upon open abdominal aortic aneurysm repair.
The inflammatory response during elective open infrarenal abdominal aortic aneurysm repair and its impact on outcome is investigated. Twenty high-risk patients were enrolled, and blood samples were obtained at 8 perioperative time points. Endotoxin, cytokines (tumor necrosis factor-alpha and interleukin-1beta, and interleukin-6), CD11b expression, and nitric oxide were measured. Peak endotoxin levels occurred within 30 minutes of reperfusion and were higher among patients developing complications. Interleukin-6 levels increased during reperfusion, reaching a peak on the first postoperative day. Interleukin-6 increase correlated with aortic clamp time and morbidity. CD11b expression increased 30 minutes after reperfusion, and this effect was greater among patients who developed complications. Endotoxin may be important in the pathogenesis of multiple organ dysfunction syndrome. Activated neutrophils may have a central role in tissue injury after reperfusion. Intraoperative CD11b upregulation may be an early marker for postoperative complications after infrarenal abdominal aortic aneurysm repair.
Vasdekis
Spyros N
SN
Vascular Unit, 3rd Department of Surgery, University Hospital 'Attikon', Athens University Medical School, Athens, Greece. vas25@otenet.gr
Argentou
Marianna
M
Kakisis
John D
JD
Bossios
Apostolos
A
Gourgiotis
Dimitrios
D
Karanikolas
Menelaos
M
Karatzas
Gabriel
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000097:blood / Q000276:immunology / Q000601:surgery*; D019540:Area Under Curve; D039481:CD11b Antigen / Q000097:blood; D004731:Endotoxins / Q000097:blood; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood; D007375:Interleukin-1 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000097:blood; D018709:Statistics, Nonparametric; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D039481:CD11b Antigen; D004731:Endotoxins; D007375:Interleukin-1; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D009569:Nitric Oxide