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The impact of anti-endotoxin core antibodies on endotoxin and cytokine release and ventilation time after cardiac surgery

Markus Rothenburger, MD^*, Rasjid Soeparwata, MD^*, Mario C. Deng, MD, FACC, FESC, Elmar Berendes, MD, Christof Schmid, MD^*, Tonny D. T. Tjan^*, Markus J. Wilhelm, MD^*, Michael Erren, MD, Dirk Böcker, MD^|| and Hans Heinrich Scheld, MD^*

^* Department of Cardiothoracic Surgery, University of Muenster, Muenster, Germany
Heart Failure Center, Columbia University, New York, New York, USA
Department of Anesthesiology and Operative Intensive Care, University of Muenster, Muenster, Germany
Institute for Clinical Laboratory Medicine, University of Muenster, Muenster, Germany
^|| Department of Cardiology and Angiology, University of Muenster, Muenster, Germany

View larger version (35K): [in a new window]   Figure 1 Time course of anti-endotoxin core antibodies perioperatively in patients undergoing coronary artery bypass graft surgery without adverse events (groups 1A and 1B) compared with that in patients with prolonged mechanical ventilation time (group 2) (mean value ± SD). Time points: 1) preoperative; 2) induction of anesthesia; 3) sternotomy; 4) cardiopulmonary bypass onset; 5) protamine reversal; 6) skin closure; 7) 30 min postoperatively; 8) 3 h postoperatively; 9) 24 h postoperatively; 10) 48 h postoperatively; and 11) 72 h postoperatively. *p < 0.01. Ig = immunoglobulin; LPS = lipopolysaccharide.

View larger version (17K): [in a new window]   Figure 2 Time course of endotoxin levels perioperatively in patients undergoing coronary artery bypass graft surgery requiring ventilation time <12 h (group 1A); 12 to 24 h (group 1B) and >24 h (prolonged ventilation; group 2) (mean value ± SD). Time points are described in Figure 1. *p < 0.001.

View larger version (24K): [in a new window]   Figure 3 Time course of interleukin-8 perioperatively in patients undergoing coronary artery bypass graft surgery requiring ventilation time <12 h (group 1A), 12 to 24 h (group 1B) and >24 h (prolonged ventilation; group 2) (mean value ± SD). Time points are described in Figure 1. *p < 0.001.