Milrinone Modulates Endotoxemia, Systemic Inflammation, and Subsequent Acute Phase Response after Cardiopulmonary Bypass (CPB)

Möllhoff, T.; Loick, H. M.; Aken, Hugo Van; Schmidt, Christoph; Rolf, Norbert; Tjan, T. D. T.; Asfour, Boulos; Berendes, Elmar

doi:10.1097/00000542-199901000-00012

Cited by 80 publications

(53 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Values are median (interquartile range). P < 0´001 (severe versus mild AP and control from the outset); P < 0´01 (mild versus control overall from 48 to 120 h) (Kruskal±Wallis and Mann±Whitney U tests) tions after cardiac surgery 36 . It is against such a background that there has been recent interest in assessing the potential value of SAA in acute pancreatitis 28,29 .…”

Section: Discussionmentioning

confidence: 99%

Serum amyloid A is a better early predictor of severity than C-reactive protein in acute pancreatitis

et al. 2002

View full text Add to dashboard Cite

Background: Serum amyloid A (SAA) is an early and sensitive marker of the extent of tissue trauma and in¯ammation. The aim of this study was to compare the early prognostic accuracy of SAA with that of serum C-reactive protein (CRP) in acute pancreatitis.Methods: In a prospective multicentre trial, plasma SAA and CRP levels were measured in patients with severe and mild acute pancreatitis, and in a control group with acute abdominal pain. Plasma samples were collected on admission and at 6-h intervals for 48 h, every 12 h between 48 and 72 h, then daily for 5 days. Plasma SAA was measured by a new enzyme-linked immunosorbent assay and CRP was measured by immunoturbidometry.Results: There were 137 patients with mild and 35 with severe acute pancreatitis, and 74 control patients. SAA levels were signi®cantly higher in patients with severe acute pancreatitis than in those with mild acute pancreatitis, on admission, at 24 h or less after symptom onset, and subsequently. Whereas plasma CRP concentration was also signi®cantly higher in patients with severe acute pancreatitis on admission, it failed to distinguish mild from severe acute pancreatitis until 30±36 h after symptom onset. SAA levels predicted severity (sensitivity 67 per cent, speci®city 70 per cent, negative predictive value 89 per cent, mean(s.d.) area under curve 0´7(0´05)) signi®cantly better than CRP (57 per cent, 60 per cent, 84 per cent, 0´59(0´06) respectively) on admission (P = 0´02) and at 24 h following symptom onset (area under curve 0´65(0´09) versus 0´58(0´09) respectively; P < 0´02).Conclusion: Plasma SAA concentration is an early marker of severity in acute pancreatitis and is superior to CRP estimation on hospital admission and at 24 h or less after symptom onset. This study suggests that plasma SAA concentration is clinically useful, with the potential to replace CRP in the management of acute pancreatitis.

show abstract

Section: Discussionmentioning

confidence: 99%

Serum amyloid A is a better early predictor of severity than C-reactive protein in acute pancreatitis

et al. 2002

View full text Add to dashboard Cite

show abstract

“…2 Of particular interest, compromised peripheral perfusion during CPB and the resulting gastrointestinal mucosal injury have been shown to lead to decreased mucosal barrier function, which may allow translocation of intestinal flora and endotoxemia and subsequently increased systemic inflammation. 3,4 This may lead to and/or further enhance oxidative stress during CPB and result in more eventful postoperative myocardial functional recovery.…”

mentioning

confidence: 99%

Propofol attenuates intestinal mucosa injury induced by intestinal ischemia-reperfusion in the rat

Liu

Rinne

et al. 2007

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

Purpose:We investigated whether propofol at a sedative dose can prevent intestinal mucosa ischemia/reperfusion (I/R) injury, and if propofol can attenuate oxidative stress and increases in nitric oxide (NO) and endothelin-1 (ET-1) release that may occur during intestinal I/R injury. Methods:Rats were randomly allocated into one of five groups (n = 10 each): (i) sham control; (ii) injury (one hour superior mesenteric artery occlusion followed by three hours reperfusion); (iii) propofol pre-treatment, with propofol given 30 min before inducing intestinal ischemia; (iv) simultaneous propofol treatment, with propofol given 30 min before intestinal reperfusion was started; (v) propofol post-treatment, with propofol given 30 min after intestinal reperfusion was initiated. In the treatment groups, propofol 50 mg·kg -1 was administrated intraperitoneally. Animals in the control and untreated injury groups received equal volumes of intralipid (the vehicle solution of propofol) intraperitoneally. Intestinal mucosa histology was analyzed by Chiu's scoring assessment. Levels of lactic acid (LD), NO, ET-1, lipid peroxidation product malondialdehyde (MDA) and superoxide dismutase (SOD) activity in intestinal mucosa were determined. Results:Histological results showed severe damage in the intestinal mucosa of the injury group accompanied by increases in MDA, NO and ET-1 and a decrease in SOD activity. Propofol treatments, especially pre-treatment, significantly reduced Chiu's scores and levels of MDA, NO, ET-1 and LD, while restoring SOD activity. Conclusion:These findings indicate that propofol attenuates intestinal I/R-induced mucosal injury in an animal model. The response may be attributable to propofol's antioxidant properties, and the effects of inhibiting over-production of NO and in decreasing ET-1 levels. CAN J ANESTH 2007 / 54: 5 / pp 366-374 Objectif : Nous avons cherché à savoir si le propofol, en dose sédative, pouvait empêcher les lésions d'ischémie/reperfusion (I/R) de la muqueuse intestinale, et s'il pouvait atténuer le stress oxydatif et les augmentations dans la libération d'oxyde nitrique (NO) et d'endothéline-1 (ET-1) pouvant survenir lors de lésions I/R intestinales. Méthode : Des rats ont été randomisés en cinq groupes (n = 10 chacun) : (i) faux témoin (sham control) ; (ii) lésion (occlusion de

show abstract

“…For this reason, PDE 3 inhibitors, which have a positive inotropic effect and a vasodilating effect on the diseased human heart, were considered as favorable for tissue oxygen delivery in general. In particular, olprinone more powerfully enhances hepatosplanchnic blood flow and improves hepatosplanchnic oxygen metabolism, in comparison with other PDE 3 inhibitors, milrinone and amrinone [52][53][54].…”

Section: Splanchnic Organsmentioning

confidence: 95%

The Effects of Olprinone, a Phosphodiesterase 3 Inhibitor, on Systemic and Cerebral Circulation

Ueda¹,

Mizushige

2006

CVP

View full text Add to dashboard Cite

Olprinone, a phosphodiesterase (PDE) 3 inhibitor, is used to treat heart failure due to its positive inotropic and vasodilative effects. Selective inhibition of the PDE 3 isozyme increases intracellular adenosine 3;5;-cyclic monophosphate and enhances Ca(2+) influx into cardiac muscle cells. The most significant advantage of PDE 3 inhibitors is their ability not only to enhance myocardial contraction, but to reduce, through vasodilatory action, the stress to which the heart is subjected. In peripheral vessels, the decrease of cytosolic free Ca(2+) induces the vasorelaxation of vascular smooth muscle cells. In this way, olprinone reduces mean aortic and pulmonary artery pressures. Additionally, olprinone exerts differential vasodilatory effects on peripheral vessels in each organ, based on the differences in the distribution of PDE 3 among the organs. With respect to the cerebral circulation, olprinone augments blood flow in the cerebral cortex through direct vasodilatory effects on small cerebral arteries or arterioles. Olprinone increases hepatosplanchnic blood flow and improves oxygen supply. While long-term therapy with PDE 3 inhibitors in patients with chronic heart failure may accelerate the progress of the underlying disease and provoke serious ventricular arrhythmia, olprinone shows good potential for short-term treatment in patients who have experienced severe heart failure or patients who have undergone cardiac surgery.

show abstract

Milrinone Modulates Endotoxemia, Systemic Inflammation, and Subsequent Acute Phase Response after Cardiopulmonary Bypass (CPB)

Abstract: Perioperative administration of low-dose milrinone may have antiinflammatory properties and may improve splanchnic perfusion in otherwise healthy patients undergoing routine coronary artery bypass grafting.

Cited by 80 publications

References 34 publications

Serum amyloid A is a better early predictor of severity than C-reactive protein in acute pancreatitis

Serum amyloid A is a better early predictor of severity than C-reactive protein in acute pancreatitis

Propofol attenuates intestinal mucosa injury induced by intestinal ischemia-reperfusion in the rat

The Effects of Olprinone, a Phosphodiesterase 3 Inhibitor, on Systemic and Cerebral Circulation

Contact Info

Product

Resources

About