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Endotoxins in cardiopulmonary bypass
L Nilsson1, L Kulander, S O Nyström
1Department of Thoracic Surgery, University Hospital, Uppsala, Sweden.
The Journal of Thoracic and Cardiovascular Surgery
|November 1, 1990
Summary
Endotoxins, bacterial substances, can contaminate medical devices. This study measured endotoxin levels during heart bypass surgery, finding increases but no clear link to patient illness.
Area of Science:
- Biochemistry
- Medical Device Contamination
- Bacterial Endotoxins
Background:
- Endotoxins are biologically active substances from gram-negative bacteria.
- Sterile water and medical materials, like extracorporeal components for cardiopulmonary bypass, can harbor endotoxins.
- Endotoxin presence in hemodialysis is linked to adverse patient effects.
Purpose of the Study:
- To determine serum endotoxin concentrations in patients undergoing coronary bypass operations.
- To investigate potential endotoxin release from extracorporeal equipment during cardiopulmonary bypass.
- To assess the relationship between endotoxin levels and postoperative morbidity.
Main Methods:
- Serum endotoxin concentration was measured using the limulus amebocyte lysate test.
- 42 patients undergoing coronary bypass operations were included in the study.
- Endotoxin levels were monitored during cardiopulmonary bypass.
Main Results:
- Serum endotoxin levels increased during cardiopulmonary bypass in 10 out of 42 patients.
- Elevated endotoxin levels exceeded the normal range (0-20 ng/L), reaching a maximum of 82 ng/L.
- No clear relationship was found between endotoxin levels and postoperative morbidity.
Conclusions:
- Increased endotoxin levels during cardiopulmonary bypass likely indicate release from extracorporeal equipment.
- The observed endotoxin levels were lower than those reported in previous studies, possibly due to reduced contamination or differing analytic methods.