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Endothelium response to prolonged extracorporeal circulation

Bogusława Plˆąskowska, Barbara Adamik, Paweł S. Berezowicz, Andrzej KŸubler

Med Sci Monit 1999; 5(3): CR452-455

ID: 504830

Background: We studied the plasma levels of soluble adhesion molecules in patients undergoing cardiac surgery in extracorporeal circulation (ECC). We investigated the relationships between the levels of adhesins released during the major surgery in ECC and development of postoperative complications. We assessed 10 patients undergoing elective cardiac surgery with flat-sheet membrane oxygenation. The soluble vascular cell adhesion molecule (sVCAM-1), soluble intercellular adhesion molecule (sICAM-1), soluble endothelial leukocyte adhesion molecule (sELAM-1), lactate levels and WBC were measured before induction of anesthesia, after ECC, one and two days after operation. Results: Plasma sELAM-1 levels were in normal range in both studied groups, with and without complications. Plasma sICAM-1 levels were also low in the group of patients without complications during the whole studied period. We observed the increasing sICAM-1 concentrations with the peak on the 2nd day in the group of patients with complications. We found the elevated plasma concentrations of sVCAM-1 during the whole time of study; they were significantly higher in four patients who postoperatively developed multiple organ dysfunction syndrome than in those with uneventful recovery. Conclusions: Extracorporeal circulation with membrane oxygenation is followed by a endothelium response and release of soluble adhesion molecules into the bloodstream. There is a correlation between the markedly increasing level of sVCAM-1 and sICAM-1 and the appearance of postoperative complications.

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