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The Annals of Thoracic Surgery, Vol 54, 744-747, Copyright © 1992 by The Society of Thoracic Surgeons
NJ Jansen, W van Oeveren, YJ Gu, MH van Vliet, L Eijsman and CR Wildevuur
Endotoxin, when released into the systemic circulation during
cardiopulmonary bypass (CPB), might induce activation of plasmatic systems
and blood cells during CPB, in addition to a material-dependent blood
activation during CPB. However, the role of endotoxin in the development of
this so-called whole-body inflammatory reaction in CPB is still unclear. We
investigated the release of endotoxin into the systemic circulation in
relation with the activation of the complement system and in particular the
formation of tumor necrosis factor in 10 patients undergoing CPB.
Immediately after the start of CPB the endotoxin concentrations increased
significantly (p less than 0.01), accompanied by increases in C3a
concentration (p less than 0.05). After release of the aortic cross-clamp,
there was a second increase in endotoxin followed by a continuous increase
in tumor necrosis factor, reaching a peak concentration 1 hour after the
end of CPB (p less than 0.01). These observations demonstrate a release of
endotoxin into the systemic circulation associated with tumor necrosis
factor formation, which contributes to the whole-body inflammatory reaction
associated with CPB.
ARTICLES
Endotoxin release and tumor necrosis factor formation during cardiopulmonary bypass
Department of Cardiopulmonary Surgery Research Division, University Hospital Groningen, The Netherlands.
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