Increased concentrations of cytokines and adhesion molecules in patients after repair of abdominal aortic aneurysm.

A.H. Froon, J.W.M. Greve, C.J. van der Linden, W.A. Buurman

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Abstract

Increased concentrations of cytokines and adhesion molecules in patients after repair of abdominal aortic aneurysm.

Froon AH, Greve JW, Van der Linden CJ, Buurman WA.

Department of Surgery, University Hospital Maastricht, The Netherlands.

OBJECTIVE: To evaluate the association between inflammatory mediators and clinical outcome in patients after repair of abdominal aortic aneurysms. DESIGN: Prospective study. SETTING: University hospital, The Netherlands. PATIENTS: 30 Consecutive patients who had undergone elective or acute repair of abdominal aortic aneurysms. MAIN OUTCOME MEASURES: Plasma concentrations of the cytokines tumour necrosis factor (TNF), interleukin-6 (IL-6) and interleukin-8 (IL-8) as well as soluble TNF receptors and the soluble (s) adhesion molecules E-selectin and intercellular adhesion molecule 1 (ICAM-1) were measured and correlated with the degree of systemic hypotension (shock: hypotension more than 15 minutes) and clinical outcome. RESULTS: Peak plasma concentrations of TNF and IL-6 were significantly higher in shocked patients (p < 0.005 and p < 0.0005, respectively) and those who died (both p < 0.01), whereas concentrations of IL-8 increased only when shock complicated rupture of the aneurysm (p < 0.01). Increases in the concentrations of TNF receptors reflected impaired renal function. In contrast to sE-selectin concentrations, peak sICAM-1 concentrations were significantly higher in shocked patients (p < 0.01) and those that died (p < 0.01). CONCLUSIONS: These results strongly suggest that increased concentrations of sICAM-1 and IL-6 reflect the inflammatory response induced by ischaemia after repair of an abdominal aortic aneurysm, and indicate that the postoperative course is likely to be complicated.
Original languageEnglish
Pages (from-to)287-296
JournalEuropean Journal of Surgery
Volume162
Publication statusPublished - 1 Jan 1996

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