Related Experiment Videos
Perioperative alterations in plasma endothelin-1 and echocardiographic correlates of right heart function
D Amar1, M Fleisher, D H Leung
1Department of Anesthesiology and Critical Care Medicine, Memorial Sloan-Kettering Cancer Center and Cornell University Medical College, New York, NY 10021, USA.
Objective:
To determine whether greater changes in plasma endothelin-1 (ET-1) concentrations and right ventricular systolic pressure occur after major thoracic surgery than after major abdominal operations.
Design:
Prospective study.
Setting:
University hospital.
Participants:
Patients undergoing elective thoracotomies (n = 12) or laparotomies (n = 10).
Interventions:
ET-1 was measured from blood obtained before anesthesia and again on postoperative days 1, 2, 3, and 5 (or 6). Transthoracic echocardiography was performed before surgery and on postoperative day 2 to evaluate right-sided heart function.
Measurements And Main Results:
After abdominal and thoracic surgery, systemic and estimated pulmonary vascular pressures were normal in both groups and unaffected by surgery. Plasma ET-1 concentrations decreased from baseline values during the first postoperative week with no differences between the groups.
Conclusions:
In patients without organic heart disease, plasma ET-1 levels do not increase in response to major abdominal or thoracic surgery. Whether or not plasma ET-1 concentrations are elevated in patients developing clinically significant postoperative pulmonary hypertension requires further study.