The inflammatory response during elective open infrarenal abdominal
aortic aneurysm repair and its impact on outcome is investigated. Twenty
high-risk patients were enrolled, and blood samples were obtained at 8
perioperative time points. Endotoxin, cytokines (tumor necrosis
factor-alpha and interleukin-1 beta, and interleukin-6), CD11b)
expression, and nitric oxide were measured. Peak endotoxin levels
occurred within 30 minutes of reperfusion and were higher among patients
developing complications. Interleukin-6 levels increased during
reperfusion, reaching a peak on the first postoperative day.
Interleukin-6 increase correlated with aortic clamp time and morbidity
CD11b expression increased 30 minutes after reperfusion, and this effect
was greater among patients who developed complications. Endotoxin may be
important in the pathogenesis of multiple organ dysfunction syndrome.
Activated neutrophils may have a central role in tissue injury after
reperfusion. Intraoperative CD11b upregulation may be an early marker
for postoperative complications after infrarenal abdominal aortic
aneurysm repair
