ORIGINAL ARTICLES  VASCULAR PAPERS 

The Journal of Cardiovascular Surgery 1998 October;39(5):547-9

Copyright © 2000 EDIZIONI MINERVA MEDICA

language: English

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.