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[Role of endogenous intoxication in multiple organ dysfunction development in cardiosurgical patients in early
Purpose:
to evaluate endogenous intoxication (EI) and multiple organ dysfunction (MOD) in cardiosurgical patients after open heart surgery.
Patients And Methods:
twenty six patients with MOD signs and 29 patients with an uneventful postoperative period were studied. MOD severity was assessed with SOFA scoring. EI was quantified with middle molecular weight peptides (MMWP), malondialdehyde and couple triens.
Results:
on the first postoperative day MOD patients were characterized by high EI (MMWP: +36.7%), while control patients had a mild EI (MMWP: +20.7%). On the 3rd-4th postoperative days in the main group SOFA scores was decreased and EI intensity was increased (MMWP: +43.3%), while in the control group EI fitted the preoperative value. The major defference on the 10th-12th postoperative day was observed. In the main group severity of MOD matched that over the previous period. The intensity of EI remained elevated (MMWP: +30%), while in the control group EI level was equal to the baseline. The correlation analysis showed a positive relationship between EI and MOD pareameters, and positive connection between EI/MOD parameters and cardiopulmonary bypass/aortal occlusion duration.
Conclusion:
patients with MOD have more considerable EI compared with an uneventful postoperative period. EI increase is one of the main causes of MOD development in cardiac surgery patients. Cardiopulmonary bypass/aortal occlusion potentiate endogenous intoxication and MOD development after cardiac surgery.
Insights
Patients undergoing open heart surgery with multiple organ dysfunction (MOD) exhibit higher endogenous intoxication (EI) levels. EI contributes to MOD development, exacerbated by cardiopulmonary bypass and aortic occlusion.
Area of Science:
- Cardiovascular Surgery
- Critical Care Medicine
- Biochemistry
Context:
- Open heart surgery patients are susceptible to postoperative complications.
- Multiple organ dysfunction (MOD) is a severe outcome following cardiac procedures.
- Endogenous intoxication (EI) is implicated in the pathophysiology of MOD.
Purpose:
- To evaluate endogenous intoxication (EI) and multiple organ dysfunction (MOD) in cardiosurgical patients.
- To compare EI and MOD levels between patients with and without an uneventful postoperative period.
- To investigate the relationship between EI, MOD, and surgical factors like cardiopulmonary bypass duration.
Summary:
- Patients with MOD showed significantly higher EI levels (measured by MMWP) compared to controls.
- EI intensity increased in MOD patients while MOD severity decreased, suggesting EI's role in sustained organ dysfunction.
- A positive correlation was found between EI, MOD parameters, and the duration of cardiopulmonary bypass and aortic occlusion.
Impact:
- Findings suggest EI is a key factor in MOD development post-cardiac surgery.
- Cardiopulmonary bypass and aortic occlusion appear to potentiate both EI and MOD.
- Understanding EI's role can inform strategies to mitigate MOD in high-risk surgical patients.
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