Neutrophil leukotriene generation and pulmonary dysfunction after abdominal aortic aneurysm repair.
Academic Article
Overview
abstract
BACKGROUND: The purpose of this study was to assess the role of polymorphonuclear neutrophil (PMN)-generated leukotriene B4 (LTB4) as an etiologic agent in the pulmonary dysfunction seen after operation in patients undergoing abdominal aortic aneurysm repair. METHODS: Blood was analyzed in 10 consecutive patients undergoing elective infrarenal abdominal aortic aneurysm repair for plasma thromboxane B2, lactoferrin, C3a, and PMN-generated LTB4. RESULTS: There was a close linear correlation (r = 0.88; p < 0.001) between aortic clamp time and PMN LTB4 production. Conversely, aortic clamp time and the ratio of arterial oxygen pressure to fraction of inspired oxygen, a measure of pulmonary function, were inversely related (r = -0.80; p < 0.008). PMNs from patients with long aortic cross-clamp times generated three times more LTB4 than those patients with short cross-clamp times (194 +/- 29.6 vs 64.9 +/- 9.7 ng per 5 x 10(6) PMN; p < 0.05). Similarly, the pressure/inspired oxygen ratio was significantly lower on admission to the intensive care unit in patients with long cross-clamp times as compared with patients with short cross-clamp times (237 +/- 14 vs 342 +/- 5; p < 0.005). In addition, patients with long cross-clamp times remained intubated longer than patients with short times (1.6 +/- 0.2 vs 0.6 +/- 0.4 days; p < 0.05). CONCLUSIONS: These data suggest a causal role for LTB4 in the generation of pulmonary dysfunction in patients undergoing abdominal aortic aneurysm repair, similar to what has been shown in animal models.
