Abstract

ObjectiveExperimental models show that apolipoprotein CI (apoCI) binds and enhances the inflammatory response to endotoxin. We studied in patients undergoing cardiopulmonary bypass surgery (CPB) and experiencing endotoxemia during reperfusion whether plasma apoCI levels correlate with the inflammatory response and perioperative cytokine release.DesignProspective, observational, clinical cohort study.SettingOperating room (OR) and intensive care unit (ICU) of a university hospital.PatientsOne hundred fifty-nine consecutive patients > 18 years of age (66% males (n = 105), median age 65 and 67 years for males and females, respectively) undergoing elective cardiothoracic surgery with cardiopulmonary bypass.InterventionsNone.MeasurementsBaseline apoCI, apoCIII, total cholesterol and triglyceride levels, and perioperative endotoxin and TNF-α levels were determined.ResultsHigh preoperative plasma apoCI, but not apoCIII, levels were associated (p < 0.05) with increased perioperative levels of TNF-α in patients experiencing endotoxemia. This association was not observed in patients without endotoxemia.ConclusionHigh plasma apoCI is positively related to proinflammatory response in patients experiencing endotoxemia and confirms the observations in animal models.

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