title: [Role of endogenous intoxication in multiple organ dysfunction development in cardiosurgical patients in early postoperative period].
abstract: OBJECTIVE
  to evaluate endogenous intoxication (EI) and multiple organ dysfunction (MOD) in cardiosurgical patients after open heart surgery.
  
  
  METHODS
  twenty six patients with MOD signs and 29 patients with an uneventful postoperative period were studied. MOD severity was assessed with SOFA scoring. EI was quantified with middle molecular weight peptides (MMWP), malondialdehyde and couple triens.
  
  
  RESULTS
  on the first postoperative day MOD patients were characterized by high EI (MMWP: +36.7%), while control patients had a mild EI (MMWP: +20.7%). On the 3rd-4th postoperative days in the main group SOFA scores was decreased and EI intensity was increased (MMWP: +43.3%), while in the control group EI fitted the preoperative value. The major defference on the 10th-12th postoperative day was observed. In the main group severity of MOD matched that over the previous period. The intensity of EI remained elevated (MMWP: +30%), while in the control group EI level was equal to the baseline. The correlation analysis showed a positive relationship between EI and MOD pareameters, and positive connection between EI/MOD parameters and cardiopulmonary bypass/aortal occlusion duration.
  
  
  CONCLUSIONS
  patients with MOD have more considerable EI compared with an uneventful postoperative period. EI increase is one of the main causes of MOD development in cardiac surgery patients. Cardiopulmonary bypass/aortal occlusion potentiate endogenous intoxication and MOD development after cardiac surgery.
mesh_terms: D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D002315:Cardiopulmonary Bypass / Q000009:adverse effects / Q000379:methods; D006801:Humans; D008315:Malondialdehyde / Q000378:metabolism*; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology* / Q000503:physiopathology; D017202:Myocardial Ischemia / Q000473:pathology; D011184:Postoperative Period; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D008315:Malondialdehyde