Role of endogenous XXXX as a predictive marker of @entity7441 during cardiopulmonary bypass and postoperative severe systemic inflammatory response.

@entity1 @entity859 @entity1850 @entity881 @entity7441
OBJECTIVE: @entity1850 ( @entity1850 ) and severe @entity1850 ( @entity1850 with @entity881 ) occurring after cardiopulmonary bypass (CPB) are common causes of morbidity and mortality among cardiac surgical @entity1 . These syndromes are often preceded by a profound vasodilation, characterized by @entity7441 occurring during surgery. Many substances have been implicated in their pathophysiology. @entity859 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 @entity1850 . DESIGN: A prospective comparative observational study. SETTING: The operating room and intensive care unit of a tertiary care university hospital. @entity1 : @entity859 plasma levels (mean+/-sd; APLs) were measured before (baseline), during, and immediately after surgery in 35 @entity1 who underwent aortic valve replacement involving CPB. APLs were correlated to operative and postoperative clinical courses. MEASUREMENTS AND MAIN RESULTS: APLs were significantly higher in seven @entity1 with @entity7441 and postoperative severe @entity1850 (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 longer for @entity1 with higher APLs. Mean arterial pressure was inversely correlated with mean arterial APLs (Pearson's correlation coefficient: R=-0.66; p<.001). CONCLUSIONS: High APLs were found in @entity1 with operative @entity7441 and postoperative severe @entity1850 occurring after cardiopulmonary bypass. This suggests that @entity859 release is involved in @entity7441 that occurs during the systemic inflammatory response to cardiac surgery. Further studies are needed to clarify the association between cytokine production and @entity859 release in severe @entity1850 following cardiac surgery.
