Circulating Endotoxin and Cytokines after Cardiopulmonary Bypass: Differential Correlation with Duration of Bypass and Systemic Inflammatory Response/Multiple Organ Dysfunction Syndromes

Khabar, Khalid S.A.; Elbarbary, Mahmoud; Khouqeer, Fareed; DeVol, Edward; Al-Gain, Salah; Al-Halees, Zuhair

doi:10.1006/clin.1997.4413

Cited by 94 publications

(71 citation statements)

References 15 publications

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“…22,23 Endotoxemia has been correlated with prognosis in dogs with pyometra, 24 and there was a trend for endotoxin to be correlated with outcome in CPV, 4 but endotoxin in circulation may be transient or circulating inhibitors may interfere with measurement. 25,26 Endotoxin can be difficult to measure, 26 and the method used for this study was different from that used previously.…”

Section: Discussionmentioning

confidence: 99%

Recombinant Bactericidal/Permeability‐Increasing Protein (rBPI₂₁) for Treatment of Parvovirus Enteritis: A Randomized, Double‐Blinded, Placebo‐Controlled Trial

Otto

Jackson

Rogell

et al. 2001

Veterinary Internal Medicne

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We evaluated the ability of an antimicrobial and endotoxin-neutralizing agent, the recombinant amino terminal fragment of bactericidal permeability-increasing protein (rBPI 21 ), to decrease plasma endotoxin concentration and severity of clinical signs of canine parvovirus and to improve survival. This randomized, double-blinded, placebo-controlled clinical trial included 40 client-owned dogs and 9 normal puppies from a closed research colony. Dogs weighing Ͼ5 kg (11 lb) with fecal antigen-confirmed parvovirus and clinical signs of vomiting and diarrhea were randomly assigned to receive placebo or rBPI 21 infusion over 6 hours. Plasma endotoxin concentration was measured at 0, 3, and 6 hours of infusion. Owners chose continued medical care with either the Veterinary Hospital of the University of Pennsylvania Internal Medicine Service or a local veterinarian. Telephone follow-up was conducted at 14 days. Surviving dogs were reevaluated at Ͼ30 days (recovered group), at which time plasma samples for measurement of endotoxin concentration were obtained. Plasma endotoxin concentrations were significantly higher in dogs with parvovirus than in normal or recovered dogs. Despite 90% survival, the rBPI 21 treatment did not have a significant effect on outcome, duration of hospitalization, or plasma endotoxin concentrations. Treatment in a tertiary care hospital, however, significantly improved survival but resulted in a significantly increased duration of hospitalization. Endotoxemia occurs in dogs with parvovirus enteritis, but rBPI 21 is not associated with improved survival.

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Section: Discussionmentioning

confidence: 99%

Recombinant Bactericidal/Permeability‐Increasing Protein (rBPI₂₁) for Treatment of Parvovirus Enteritis: A Randomized, Double‐Blinded, Placebo‐Controlled Trial

Otto

Jackson

Rogell

et al. 2001

Veterinary Internal Medicne

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“…Neutrophils attach to synthetic surfaces, to each other or to platelets and monocytes leading to cell activation. Interleukin-1 (IL-1), TNF-α, IL-6, IL-8, Interleukin-10 (IL-10), complement5b-9 (C5b-9), factor XIIa, heparin, histamine, hypochlorous acid and arachidonic acid metabolites including leukotriene B4 (LTB4), platelet activating factor (PAF) and thromboxane A2, prostaglandins and vasoactive cytotoxic substances are released by these activated cells and mediate most of the findings of "systemic inflammatory response syndrome" (SIRS) associate with CPB and cardiac surgery (7)(8)(9).…”

Section: Discussionmentioning

confidence: 99%

On-Pump Cardiopulmonary Bypass Versus Off-Pump Coronary Artery Bypass Grafting Surgery: Renal And Liver Function Tests

Bayram

Zor

Erer

et al. 2016

GMJ

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Objective: Cardiopulmonary bypass (CPB) triggers systemic inflammation. Inflammatory system activation may cause deteoriation in liver and renal functions. In our study we aimed to search the effect of on-pump CPB and beating heart off-pump coronary artery bypass grafting (CABG) surgery techniques on renal and liver functions. Methods: Sixty four patients who underwent coronary artery surgery were included in the study and were divided into two groups: on-pump CPB group (40) and beating heart off-pump CABG group (24), prospectively. The blood samples were collected for preoperative and postoperative levels of blood urea nitrogen (BUN), creatinine, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and AST to ALT ratio at 24 th and 48 th hours. Results: Clinical and demographic features were similar in both groups. There were no statistically significant difference in levels of preoperative BUN, creatinine, AST, ALT, AST to ALT ratio. The postoperative 24 th hour plasma levels of creatinine, AST and AST/ALT were lower in beating heart off-pump CABG group but BUN and ALT levels were similar among the two groups. The postoperative 48 th hour plasma levels of BUN, creatinine, AST and AST/ALT were lower in beating heart off-pump CABG group but levels of ALT were similar in both groups. Conclusion: Based on our findings we conclude that beating heart off-pump CABG has lower negative effect on liver and renal function than on-pump CPB. Abstract of this manuscript was presented in 7th Congress of Update in Cardiology and Cardiovascular Surgery in association with TCT Mediterranean as a poster.Key Words: Acute kidney injury, cardiopulmonary bypass, coronary artery bypass, coronary artery bypass, off-pump, liver. Anahtar Sözcükler: Akut böbrek hasarı, kardiyopulmoner bypass, koroner arter bypass, off-pump koroner arter bypass graftleme, karaciğer. ReceivedGeliş Tarihi:

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“…Numerous studies [13,20,22,23,24,25] have previously shown during and immediately after CPB significant increases in plasma endotoxin values as measured by the Limulus amoebocyte lysate (LAL) [26] assay, which is based on endotoxin being able to activate an enzyme in a dose-dependent manner. However, this assay is limited by the cross-reactivity of the enzyme to certain compounds other than endotoxin, such as glucans.…”

Section: Discussionmentioning

confidence: 99%

Association between Endotoxin Activity and Acute Kidney Injury in Cardiac Patients Undergoing Cardiopulmonary Bypass

Paternoster

Rubino

Balducci³

et al. 2014

Blood Purif

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Background/Aims: Cardiopulmonary bypass (CPB) has been thought to promote endotoxin translocation from the gut. Increased endotoxin activity (EA) has been related to a worsening of organ dysfunction, particularly acute kidney injury (AKI). This study aims to determine if CPB could influence EA after cardiac surgery, and if EA variations are associated with renal dysfunction following CPB. Methods: This was an observational study of patients subjected to complex cardiac surgery, likely to last for >120 min. Blood samples were obtained before, during and after CPB for EA analysis. AKI occurrence defined by the Acute Kidney Injury Network criteria was evaluated. Results: Eighteen patients were enrolled. EA significantly increased after 12 h following CPB. Variations of EA from baseline were significantly associated with variations of creatinine, i.e. AKI. Conclusion: Complex cardiac surgery requiring long CPB promotes EA increases that could be associated with variations of serum creatinine and AKI occurrence.

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Circulating Endotoxin and Cytokines after Cardiopulmonary Bypass: Differential Correlation with Duration of Bypass and Systemic Inflammatory Response/Multiple Organ Dysfunction Syndromes

Cited by 94 publications

References 15 publications

Recombinant Bactericidal/Permeability‐Increasing Protein (rBPI₂₁) for Treatment of Parvovirus Enteritis: A Randomized, Double‐Blinded, Placebo‐Controlled Trial

Recombinant Bactericidal/Permeability‐Increasing Protein (rBPI₂₁) for Treatment of Parvovirus Enteritis: A Randomized, Double‐Blinded, Placebo‐Controlled Trial

On-Pump Cardiopulmonary Bypass Versus Off-Pump Coronary Artery Bypass Grafting Surgery: Renal And Liver Function Tests

Association between Endotoxin Activity and Acute Kidney Injury in Cardiac Patients Undergoing Cardiopulmonary Bypass

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Circulating Endotoxin and Cytokines after Cardiopulmonary Bypass: Differential Correlation with Duration of Bypass and Systemic Inflammatory Response/Multiple Organ Dysfunction Syndromes

Cited by 94 publications

References 15 publications

Recombinant Bactericidal/Permeability‐Increasing Protein (rBPI21) for Treatment of Parvovirus Enteritis: A Randomized, Double‐Blinded, Placebo‐Controlled Trial

Recombinant Bactericidal/Permeability‐Increasing Protein (rBPI21) for Treatment of Parvovirus Enteritis: A Randomized, Double‐Blinded, Placebo‐Controlled Trial

On-Pump Cardiopulmonary Bypass Versus Off-Pump Coronary Artery Bypass Grafting Surgery: Renal And Liver Function Tests

Association between Endotoxin Activity and Acute Kidney Injury in Cardiac Patients Undergoing Cardiopulmonary Bypass

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Recombinant Bactericidal/Permeability‐Increasing Protein (rBPI₂₁) for Treatment of Parvovirus Enteritis: A Randomized, Double‐Blinded, Placebo‐Controlled Trial

Recombinant Bactericidal/Permeability‐Increasing Protein (rBPI₂₁) for Treatment of Parvovirus Enteritis: A Randomized, Double‐Blinded, Placebo‐Controlled Trial