Endotoxemia in coronary artery bypass surgery: A comparison of the off-pump technique and conventional cardiopulmonary bypass

Aydin, Naz Bige; Gerçekoğlu, Hakan; Aksu, Burak; Özkul, Vedat; Şener, Tufan; Kıygıl, İlknur; Turkoglu, Tansel; Çimen, Serdar; Babacan, Funda; Demirtaş, Murat

doi:10.1067/mtc.2003.323

Cited by 44 publications

(37 citation statements)

References 28 publications

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“…It is possible that raised plasma LPS levels during CPB may trigger this CD163 shedding [17]. Such endotoxemia is thought to occur by gastrointestinal translocation and is less evident during OPCAB surgery [18].…”

Section: Discussionmentioning

confidence: 99%

Anti-inflammatory haemoglobin scavenging monocytes are induced following coronary artery bypass surgery

Philippidis¹,

Athanasiou²,

Nadra³

et al. 2010

European Journal of Cardio-Thoracic Surgery

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Coronary artery bypass surgery induces monocyte-associated anti-inflammatory and immunoregulatory responses. There was no significant difference in haemolysis although the effect on monocyte CD163 and plasma sCD163 concentration was significantly different between the two groups. Compensation for varying pro-inflammatory and haemolytic insults may explain the differences observed. Therapeutic strategies for inducing such desirable circulating monocytes may potentially improve surgical outcome and patient recovery.

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Section: Discussionmentioning

confidence: 99%

Anti-inflammatory haemoglobin scavenging monocytes are induced following coronary artery bypass surgery

Philippidis¹,

Athanasiou²,

Nadra³

et al. 2010

European Journal of Cardio-Thoracic Surgery

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“…Furthermore, an increase in intestinal permeability and bacterial translocation (BT) has been demonstrated not only in animal models but also in patients during CPB [3,25,26] . Therefore, gastrointestinal integrity during the perioperative period is now recognized as an important factor for outcome of cardiac surgical procedures.…”

Section: Discussionmentioning

confidence: 99%

Effects of cardiopulmonary bypass on tight junction protein expressions in intestinal mucosa of rats

Sun¹,

Chen²,

Zhang³

et al. 2008

WJG

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AIM:To investigate the tight junction protein expressions of intestinal mucosa in an experimental model of cardiopulmonary bypass (CPB) in rats. METHODS: Thirty anesthetized rats were randomly divided into two groups: Group S (n = 10) served as sham operation and group C (n = 20) served as CPB which underwent CPB for 1 h. Expression of occludin and zonula occludens-1 (ZO-1) were determined by Western blotting and immunocytochemistry, respectively. Plasma levels of diamine oxidase (DAO) and d -lactate were determined using an enzymatic spectrophotometry. RESULTS: Immunohistochemical localization of occludin and ZO-1 showed disruption of the tight junctions in enterocytes lining villi at the end of CPB and 2 h after CPB. The intensities of the occludin and ZO-1 at the end of CPB were lower than those of control group (76.4% ± 22.5% vs 96.5% ± 28.5% and 62.4% ± 10.1% vs 85.5% ± 25.6%, P < 0.05) and were further lower at 2 h after CPB (50.5% ± 10.5% and 45.3% ± 9.5%, P < 0.05). Plasma d -lactate and DAO levels increased significantly (8.688 ± 0.704 vs 5.745 ± 0.364 and 0.898 ± 0.062 vs 0.562 ± 0.035, P < 0.05) at the end of CPB compared with control group and were significantly higher at 2 h after CPB than those at the end of CPB (9.377 ± 0.769 and 1.038 ± 0.252, P < 0.05). There were significant negative correlations between occludin or ZO-1 expression and DAO (r 2 = 0.5629, r 2 = 0.5424, P < 0.05) or d -lactate levels (r 2 = 0.6512, r 2 = 0.7073, P < 0.05) both at the end of CPB and 2 h after CPB. CONCLUSION: CPB markedly down-regulates the expression of occludin and ZO-1 proteins in intestinal mucosa of rats. The close correlation between expression of tight junctions (TJs) and plasma levels of DAO or d -lactate supports the hypothesis that intestinal permeability increases during and after CPB because of decreases in the expressions of TJs.

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“…Several studies have demonstrated that even the usual use of CPB could induce endotoxemia. 14,15 Much stress, such as bacteremia and heart failure in the case of IE, induces mesenteric vasoconstriction, thus shunting blood toward more vital organs such as the heart and brain; the gut is one of the organs most susceptible to hypoperfusion. 16 Furthermore, cardioplegic arrest under the use of CPB should worsen any preexisting intestinal hypoperfusion.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative direct hemoperfusion with a polymyxin-B immobilized fiber column for treatment of infective endocarditis

Totsugawa¹,

Kurabayashi²,

Yoshitaka³

et al. 2011

Gen Thorac Cardiovasc Surg

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Endotoxemia in coronary artery bypass surgery: A comparison of the off-pump technique and conventional cardiopulmonary bypass

Abstract: In conclusion, this study has shown that endotoxemia during coronary artery bypass surgery seems mainly to be associated with cardiopulmonary bypass procedure. The relatively lower endotoxin levels observed in off-pump surgery might contribute to improved postoperative recovery.

Cited by 44 publications

References 28 publications

Anti-inflammatory haemoglobin scavenging monocytes are induced following coronary artery bypass surgery

Anti-inflammatory haemoglobin scavenging monocytes are induced following coronary artery bypass surgery

Effects of cardiopulmonary bypass on tight junction protein expressions in intestinal mucosa of rats

Intraoperative direct hemoperfusion with a polymyxin-B immobilized fiber column for treatment of infective endocarditis

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