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Rivista di Chirurgia Cardiaca, Vascolare e Toracica
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ORIGINAL ARTICLES VASCULAR PAPERS
The Journal of Cardiovascular Surgery 1998 Ottobre;39(5):547-9
Endotoxemia after elective surgery for abdominal aortic aneurysm and the effect of early oral feeding
Sugita T.*, Watarida Sh., Katsuyama K., Nakajima Y., Yamamoto R., Matsuno S., Tabata R., Mori A.
From the Second Department of Cardiovascular Surgery Shiga University of Medical Science, Otsu, Japan
* Department of Cardiovascular Surgery Tenri Hospital, Tenri, Japan
Background. Endotoxemia after major vascular surgery has been suggested to be caused by the passage of bacterial endotoxins through the gut. Early enteral feeding has been reported to prevent bacterial translocation. Therefore, we investigated the incidence of endotoxemia in 12 patients with normal liver function after elective surgery for abdominal aortic aneurysm.
Methods. Blood samples were taken from the brachial vein of each patient before surgery, 1 day after surgery, and 3 days after surgery. The endotoxin concentration was measured using a chromogenic endotoxin-specific assay.
Results. The endotoxin concentration was significantly higher one day after surgery (2.15±1.36 pg/ml) than that before surgery (1.27±1.00 pg/mL), (p<0.05). The mean endotoxin concentration in the patients after early oral feeding (0.74±0.74 pg/ml) was significantly lower than that in the patients who could not eat (1.58±0.48 pg/ml).
Conclusions. A low concentration of systemic endotoxins can be observed after surgery for abdominal aortic aneurysm, and early oral feeding prevented this elevation.