TY - JOUR
T1 - Transient increase in interleukin-8 and pulmonary microvascular permeability following aortic surgery
AU - Raijmakers, P G
AU - Groeneveld, A B
AU - Rauwerda, J A
AU - Schneider, A J
AU - Teule, G J
AU - Hack, C E
AU - Thijs, L G
PY - 1995/3
Y1 - 1995/3
N2 - Aortic surgery results in ischemia/reperfusion of the lower body. This may liberate inflammatory mediators that activate neutrophils, and may result in lung microvascular changes with increased permeability and respiratory failure. We studied circulating inflammatory mediators and the pulmonary leak index (PLI) of 67Ga, a measure of transvascular transferrin transport and permeability, in patients scheduled for elective aortic and peripheral vascular surgery, before and after surgery. Aortic surgery patients in Groups 1 (n = 10) and 2 (n = 7) were studied before and at a median of 2.5 and 21.0 h after surgery, respectively. A control Group 3 (n = 6) was studied before and at a median of 2.9 h after peripheral vascular surgery. The PLI (median) increased from a median of 9.1 (range, 6.6 to 14.7) before to a median of 23.4 (range, 18.7 to 86.4) x 10(-3)/min after surgery in Group 1 but not in the other groups (p < 0.001). The postoperative increase in circulating neutrophils and elastase-alpha 1-antitrypsin, a marker of neutrophil activation, was similar among the groups. Plasma levels of activated complement 3a and tumor necrosis factor (TNF-alpha) did not change in any of the groups. In contrast, plasma levels of interleukin-8 (IL-8) increased in Group 1 from < 3 (range, < 3 to 37) before to 324 (range, 36 to 868) pg/ml after surgery, but did not change in the other groups (p < 0.005). The decrease in plasma levels of angiotensin converting enzyme (ACE) was greater in Group 1 than in the other groups (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
AB - Aortic surgery results in ischemia/reperfusion of the lower body. This may liberate inflammatory mediators that activate neutrophils, and may result in lung microvascular changes with increased permeability and respiratory failure. We studied circulating inflammatory mediators and the pulmonary leak index (PLI) of 67Ga, a measure of transvascular transferrin transport and permeability, in patients scheduled for elective aortic and peripheral vascular surgery, before and after surgery. Aortic surgery patients in Groups 1 (n = 10) and 2 (n = 7) were studied before and at a median of 2.5 and 21.0 h after surgery, respectively. A control Group 3 (n = 6) was studied before and at a median of 2.9 h after peripheral vascular surgery. The PLI (median) increased from a median of 9.1 (range, 6.6 to 14.7) before to a median of 23.4 (range, 18.7 to 86.4) x 10(-3)/min after surgery in Group 1 but not in the other groups (p < 0.001). The postoperative increase in circulating neutrophils and elastase-alpha 1-antitrypsin, a marker of neutrophil activation, was similar among the groups. Plasma levels of activated complement 3a and tumor necrosis factor (TNF-alpha) did not change in any of the groups. In contrast, plasma levels of interleukin-8 (IL-8) increased in Group 1 from < 3 (range, < 3 to 37) before to 324 (range, 36 to 868) pg/ml after surgery, but did not change in the other groups (p < 0.005). The decrease in plasma levels of angiotensin converting enzyme (ACE) was greater in Group 1 than in the other groups (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
KW - Aged
KW - Aortic Diseases/physiopathology
KW - Capillary Permeability/physiology
KW - Ischemia-reperfusion injury
KW - lung injury
KW - Pulmonary Edema/etiology
KW - Female
KW - Gallium Radioisotopes
KW - Humans
KW - Inflammation Mediators/metabolism
KW - Interleukin-8/blood
KW - Lung/blood supply
KW - Male
KW - Endothelial barrier function
KW - Neutrophil Activation/physiology
KW - Peptidyl-Dipeptidase A/metabolism
KW - Peripheral Vascular Diseases/physiopathology
KW - Postoperative Complications/etiology
KW - Radionuclide Imaging
KW - Reperfusion Injury/etiology
KW - Respiratory Distress Syndrome, Adult/etiology
KW - Sodium Pertechnetate Tc 99m
KW - Femoral Artery/pathology
KW - endothelial barrier
KW - Tumor Necrosis Factor-alpha
KW - Complement C3a
KW - aortic aneurysm repair surgery
KW - vascular surgery
U2 - 10.1164/ajrccm.151.3.7881659
DO - 10.1164/ajrccm.151.3.7881659
M3 - Article
C2 - 7881659
VL - 151
SP - 698
EP - 705
JO - American Journal of Respiratory and Critical Care Medicine
JF - American Journal of Respiratory and Critical Care Medicine
SN - 1073-449X
IS - 3 Pt 1
ER -