Role of endogenous adenosine as a predictive marker of vasoplegia during cardiopulmonary bypass and postoperative severe systemic inflammatory response

Critical Care Medicine
François KerbaulR Guieu

Abstract

Systemic inflammatory response (SIRS) and severe SIRS (SIRS with organ dysfunction) occurring after cardiopulmonary bypass (CPB) are common causes of morbidity and mortality among cardiac surgical patients. These syndromes are often preceded by a profound vasodilation, characterized by vasoplegia occurring during surgery. Many substances have been implicated in their pathophysiology. Adenosine is a strong endogenous vasodilating agent released by endothelial cells and myocytes under metabolic stress and may be involved in blood pressure failure during CPB induced by severe SIRS. A prospective comparative observational study. The operating room and intensive care unit of a tertiary care university hospital. Adenosine plasma levels (mean+/-sd; APLs) were measured before (baseline), during, and immediately after surgery in 35 patients who underwent aortic valve replacement involving CPB. APLs were correlated to operative and postoperative clinical courses. APLs were significantly higher in seven patients with vasoplegia and postoperative severe SIRS (1.6 micromol.L [0.2-2.6] vs. 0.4 micromol.L [0.1-1.0]) at baseline and during surgery. The duration of mechanical ventilation and stay in the intensive care unit were significantly lo...Continue Reading

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Citations

Sep 24, 2014·The American Journal of the Medical Sciences·Sabry OmarKenneth Nugent
Sep 5, 2009·Journal of Cardiothoracic and Vascular Anesthesia·Qian LeiLihuan Li
Jun 21, 2018·Critical Care Medicine·Mélanie GaubertLaurent Bonello
Apr 15, 2020·Scientific Reports·Namo KimJae-Kwang Shim
May 8, 2018·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Michael J JavorskiR Anthony Perez-Tamayo
Jun 20, 2017·Journal of Clinical Anesthesia·Henry LiuMichael S Green

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