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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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R. G. H. Speekenbrink, C. R. H. Wildevuur, A. Sturk, and L. Eijsman LOW-DOSE AND HIGH-DOSE APROTININ IMPROVE HEMOSTASIS IN CORONARY OPERATIONS J. Thorac. Cardiovasc. Surg., August 1, 1996; 112(2): 523 - 530. [Abstract] [Full Text]
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S. K Ohri Systemic inflammatory response and the splanchnic bed in cardiopulmonary bypass Perfusion, May 1, 1996; 11(3): 200 - 212. [PDF]
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R. L. Kormos, T. A. Gasior, A. Kawai, S. M. Pham, S. Murali, B. G. Hattler, and B. P. Griffith TRANSPLANT CANDIDATE'S CLINICAL STATUS RATHER THAN RIGHT VENTRICULAR FUNCTION DEFINES NEED FOR UNIVENTRICULAR VERSUS BIVENTRICULAR SUPPORT J. Thorac. Cardiovasc. Surg., April 1, 1996; 111(4): 773 - 783. [Abstract] [Full Text]
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H. t. Velthuis, P. G. M. Jansen, H. M. Oudemans-van Straaten, G. J. van Kamp, A. Sturk, L. Eijsman, and C. R. H. Wildevuur Circulating Endothelin in Cardiac Operations: Influence of Blood Pressure and Endotoxin Ann. Thorac. Surg., March 1, 1996; 61(3): 904 - 908. [Abstract] [Full Text]
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P. Hornick and A. George Blood contact activation: pathophysiological effects and therapeutic approaches Perfusion, January 1, 1996; 11(1): 3 - 19. [PDF]
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G. E. Hill, A. Alonso, J. R. Spurzem, A. H. Stammers, and R. A. Robbins APROTININ AND METHYLPREDNISOLONE EQUALLY BLUNT CARDIOPULMONARY BYPASS-INDUCED INFLAMMATION IN HUMANS J. Thorac. Cardiovasc. Surg., December 1, 1995; 110(6): 1658 - 1662. [Abstract] [Full Text]
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H. t. Velthuis, P. G. M. Jansen, H. M. Oudemans-van Straaten, A. Sturk, L. Eijsman, and C. R. H. Wildevuur MYOCARDIAL PERFORMANCE IN ELDERLY PATIENTS AFTER CARDIOPULMONARY BYPASS IS SUPPRESSED BY TUMOR NECROSIS FACTOR J. Thorac. Cardiovasc. Surg., December 1, 1995; 110(6): 1663 - 1669. [Abstract] [Full Text]
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 P. Menasche, J. Peynet, N. Haeffner-Cavaillon, M.-P. Carreno, T. de Chaumaray, V. Dillisse, B. Faris, A. Piwnica, G. Bloch, and A. Tedgui Influence of Temperature on Neutrophil Trafficking During Clinical Cardiopulmonary Bypass Circulation, November 1, 1995; 92(9): 334 - 340. [Abstract] [Full Text]
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K. H.T. Teoh, C. A. Bradley, J. Gauldie, and H. Burrows Steroid Inhibition of Cytokine-Mediated Vasodilation After Warm Heart Surgery Circulation, November 1, 1995; 92(9): 347 - 353. [Abstract] [Full Text]
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W. Tao, J. B. Zwischenberger, T. T. Nguyen, R. A. Vertrees, L. B. McDaniel, L. K. Nutt, D. N. Herndon, and G. C. Kramer Gut mucosal ischemia during normothermic cardiopulmonary bypass results from blood flow redistribution and increased oxygen demand J. Thorac. Cardiovasc. Surg., September 1, 1995; 110(3): 819 - 828. [Abstract] [Full Text]
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J. Gonzalez, T. Morrissey, T. Byrne, R. Rizzo, and D. Wilmore Bioelectric impedance detects fluid retention in patients undergoing cardipulmonary bypass J. Thorac. Cardiovasc. Surg., July 1, 1995; 110(1): 111 - 118. [Abstract] [Full Text]
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C. T Bowles, S. K Ohri, N. Klangsuk, B. E Keogh, M. H Yacoub, and K. M Taylor Endotoxaemia detected during cardiopulmonary bypass with a modified Limulus amoebocyte lysate assay Perfusion, July 1, 1995; 10(4): 219 - 228. [Abstract] [PDF]
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J. P. A. M. Schonberger, P. A. M. Everts, and J. J. Hoffmann Systemic Blood Activation With Open and Closed Venous Reservoirs Ann. Thorac. Surg., June 1, 1995; 59(6): 1549 - 1555. [Abstract] [Full Text]
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D. A. Fullerton, R. C. McIntyre Jr., M. B. Mitchell, D. N. Campell, and F. L. Grover Lung transplantation with cardiopulmonary bypass exaggerates pulmonary vasomotor dysfunction in the transplanted lung J. Thorac. Cardiovasc. Surg., February 1, 1995; 109(2): 212 - 217. [Abstract] [Full Text]
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J. Boldt, C. Osmer, E. Schindler, L.-C. Linke, W.-A. Stertmann, and G. Hempelmann Circulating Adhesion Molecules in Cardiac Operations: Influence of High-Dose Aprotinin Ann. Thorac. Surg., January 1, 1995; 59(1): 100 - 105. [Abstract] [Full Text]
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M. Tonz, T. Mihaljevic, L. K. von Segesser, E. R. Schmid, H. I. Joller-Jemelka, P. Pei, and M. I. Turina Normothermia Versus Hypothermia During Cardiopulmonary Bypass: A Randomized, Controlled Trial Ann. Thorac. Surg., January 1, 1995; 59(1): 137 - 143. [Abstract] [Full Text]
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S. Watarida, A. Mori, M. Onoe, R. Tabata, S. Shiraishi, T. Sugita, T. Nojima, Y. Nakajima, and S. Matsuno A clinical study on the effects of pulsatile cardiopulmonary bypass on the blood endotoxin levels J. Thorac. Cardiovasc. Surg., October 1, 1994; 108(4): 620 - 625. [Abstract] [Full Text]
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B. Frering, I. Philip, M. Dehoux, C. Rolland, J. M. Langlois, and J. M. Desmonts Circulating cytokines in patients undergoing normothermic cardiopulmonary bypass J. Thorac. Cardiovasc. Surg., October 1, 1994; 108(4): 636 - 641. [Abstract] [Full Text]
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P. Menasche, S. Haydar, J. Peynet, C. D. Buit, R. Merval, G. Bloch, A. Piwnica, and A. Tedgui A potential mechanism of vasodilation after warm heart surgery: The temperature-dependent release of cytokines J. Thorac. Cardiovasc. Surg., January 1, 1994; 107(1): 293 - 299. [Abstract] [Full Text]
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