Transient increase in interleukin-8 and pulmonary microvascular permeability following aortic surgery

P G Raijmakers, A B Groeneveld, J A Rauwerda, A J Schneider, G J Teule, C E Hack, L G Thijs

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Aortic surgery results in ischemia/reperfusion of the lower body. This may liberate inflammatory mediators that activate neutrophils, and may result in lung microvascular changes with increased permeability and respiratory failure. We studied circulating inflammatory mediators and the pulmonary leak index (PLI) of 67Ga, a measure of transvascular transferrin transport and permeability, in patients scheduled for elective aortic and peripheral vascular surgery, before and after surgery. Aortic surgery patients in Groups 1 (n = 10) and 2 (n = 7) were studied before and at a median of 2.5 and 21.0 h after surgery, respectively. A control Group 3 (n = 6) was studied before and at a median of 2.9 h after peripheral vascular surgery. The PLI (median) increased from a median of 9.1 (range, 6.6 to 14.7) before to a median of 23.4 (range, 18.7 to 86.4) x 10(-3)/min after surgery in Group 1 but not in the other groups (p < 0.001). The postoperative increase in circulating neutrophils and elastase-alpha 1-antitrypsin, a marker of neutrophil activation, was similar among the groups. Plasma levels of activated complement 3a and tumor necrosis factor (TNF-alpha) did not change in any of the groups. In contrast, plasma levels of interleukin-8 (IL-8) increased in Group 1 from < 3 (range, < 3 to 37) before to 324 (range, 36 to 868) pg/ml after surgery, but did not change in the other groups (p < 0.005). The decrease in plasma levels of angiotensin converting enzyme (ACE) was greater in Group 1 than in the other groups (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Original languageEnglish
Pages (from-to)698-705
Number of pages8
JournalAmerican journal of respiratory and critical care medicine
Issue number3 Pt 1
Publication statusPublished - Mar 1995


  • Aged
  • Aortic Diseases/physiopathology
  • Capillary Permeability/physiology
  • Complement C3a
  • Endothelial barrier function
  • Female
  • Femoral Artery/pathology
  • Gallium Radioisotopes
  • Humans
  • Inflammation Mediators/metabolism
  • Interleukin-8/blood
  • Ischemia-reperfusion injury
  • Lung/blood supply
  • Male
  • Neutrophil Activation/physiology
  • Peptidyl-Dipeptidase A/metabolism
  • Peripheral Vascular Diseases/physiopathology
  • Postoperative Complications/etiology
  • Pulmonary Edema/etiology
  • Radionuclide Imaging
  • Reperfusion Injury/etiology
  • Respiratory Distress Syndrome, Adult/etiology
  • Sodium Pertechnetate Tc 99m
  • Tumor Necrosis Factor-alpha
  • aortic aneurysm repair surgery
  • endothelial barrier
  • lung injury
  • vascular surgery

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