Neutrophil elastase activity in pulmonary venous blood during lung resection.
OBJECTIVE
Neutrophil elastase has been reported to play an important role in acute lung injury, which is a major cause of postoperative mortality after pulmonary resection. Neutrophil elastase released in the lungs reaches the peripheral circulation via the pulmonary veins. This study was performed to compare neutrophil elastase activity in pulmonary venous blood (collected during lobectomy) with that in the peripheral blood, and to determine the perioperative changes of neutrophil elastase activity.


METHODS
In 34 patients undergoing lobectomy with mediastinal lymph node dissection, the leucocyte count, neutrophil count, neutrophil elastase activity and levels of tumour necrosis factor-α, interleukin-6 and interleukin-8 were measured in the pulmonary venous blood and peripheral arterial blood before and after surgery. Then, these parameters were compared between before and after surgery with peripheral and pulmonary blood.


RESULTS
Neutrophil elastase activity was found to be significantly higher in pulmonary venous blood at the completion of surgery than at the start (during thoracotomy), while the neutrophil elastase activity of peripheral arterial blood showed no significant change between the start and completion of surgery.


CONCLUSIONS
In conclusion, measurement of neutrophil elastase activity in pulmonary venous blood revealed changes associated with lobectomy.
Department of Surgery, National Hospital Organization Omuta National Hospital, Ohmuta Fukuoka, Japan. nagam2@nifty.com
Yoshinori
Y
Nagamatsu
Yasunori
Y
Iwasaki
Harutaka
H
Omura
Ryozo
R
Hayashida
Masaki
M
Kashihara
Tatsuya
T
Nishi
Koichi
K
Yoshiyama
Kazuo
K
Shirouzu
D055371:Acute Lung Injury / Q000201:enzymology* / Q000209:etiology; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019272:Leukocyte Elastase / Q000097:blood*; D008175:Lung Neoplasms / Q000556:secondary / Q000601:surgery*; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D011013:Pneumonectomy / Q000009:adverse effects*; D011183:Postoperative Complications / Q000201:enzymology / Q000209:etiology; D011379:Prognosis; D011667:Pulmonary Veins; D012189:Retrospective Studies
D019272:Leukocyte Elastase