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The Journal of Thoracic and Cardiovascular Surgery, Vol 93, 115-119, Copyright © 1987 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
LW Andersen, L Baek, H Degn, J Lehd, M Krasnik and JP Rasmussen
Ten patients having coronary artery bypass grafting were intraoperatively
and postoperatively analyzed for endotoxins with the Limulus amoebocyte
lysate test. A new highly sensitive rocket immunoelectrophoretic assay for
reading the reactions of endotoxins with Limulus amoebocyte lysate was
used. Preoperatively, all blood samples from the patients had negative
Limulus amoebocyte lysate tests, negative blood cultures, normal total
white cell counts, and were clinically without signs of infection.
Intraoperatively, a substantial amount of endotoxins were found in samples
from the extracorporeal circuit, the pulmonary artery, and the cardiac
suction lines, which persisted during the cardiopulmonary bypass. The
endotoxin content decreased significantly (p less than 0.05) 6 hours after
cardiopulmonary bypass and further decreased within the seventh
postoperative day (p less than 0.01). A positive Limulus amoebocyte lysate
test was also found in some of the fluids administered during the
operation, that is, the cardioplegic fluids, the priming fluids for the
extracorporeal circuit, the blood transfusions, and the ice for local
cooling. Postoperatively, all patients had rectal temperatures below 38.5
degrees C, but no correlation was found between the magnitude of endotoxin
content and the degree of fever. Only one of the patients had positive
blood cultures. Despite the measured endotoxin content, no intraoperative
or postoperative complications were found.
ARTICLES
Presence of circulating endotoxins during cardiac operations
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