In:
Journal of Investigative Medicine, SAGE Publications, Vol. 56, No. 6 ( 2008-08), p. 864-871
Abstract:
Adenosine (ADO) is an endogenous nucleoside, which has been involved in blood pressure failure during severe systemic inflammatory response syndrome (severe SIRS) after cardiac surgery with cardiopulmonary bypass (CPB). Adenosine acts via its receptor subtypes, namely A 1 , A 2A , A 2B , or A 3 . Because A 2A receptors are implicated in vascular tone, their expression might contribute to severe SIRS. We compared adenosine plasma levels (APLs) and A 2A ADO receptor expression (ie, B, K, and mRNA amount) in patients with or without postoperative SIRS. Patients This was a prospective comparative observational study. Forty-four patients who underwent cardiac surgery involving CPB. Ten healthy subjects served as controls. Measurements and Results Among the patients, 11 presented operative vasoplegia and postoperative SIRS (named complicated patients) and 33 were without vasoplegia or SIRS (named uncomplicated patients). Adenosine plasma levels, K, B, and mRNA amount (mean ± SD) were measured on peripheral blood mononuclear cells. Adenosine plasma levels, B, and K were significantly higher in complicated patients than in uncomplicated patients (APLs: 2.7 ± 1.0 vs 1.0 ± 0.5 μmol l −1 , P 〈 0.05; B: 210 ± 43 vs 65 ± 26 fmol/mg, P 〈 0.05; K: 35 ± 10 vs 2 ± 1 nM, P 〈 0.05). In uncomplicated patients, APLs remain higher than in controls (1 ± 0.5 vs 0.6 ± 0.25 μmol/L; P 〈 0.05). Mean arterial pressure was inversely correlated to APLs (R = −0.58; P 〈 0.001) and B (R = −0.64; P 〈 0.001) leading to an increased requirement of vasoactive drugs during the postoperative period in vasoplegic patients. Conclusions High expression of A 2A ADO receptor and high APLs may be a predictive factor of postoperative severe SIRS after CPB.
Type of Medium:
Online Resource
ISSN:
1081-5589
,
1708-8267
DOI:
10.2310/JIM.0b013e3181788d02
Language:
English
Publisher:
SAGE Publications
Publication Date:
2008
