BACKGROUND: Endotoxemia after major vascular surgery has been suggested to be caused by the passage of bacterial endotoxins through the gut. Early enteral feeding has been reported to prevent bacterial translocation. Therefore, we investigated the incidence of endotoxemia in 12 patients with normal liver function after elective surgery for abdominal aortic aneurysm. METHODS: Blood samples were taken from the brachial vein of each patient before surgery, 1 day after surgery, and 3 days after surgery. The endotoxin concentration was measured using a chromogenic endotoxin-specific assay. RESULTS: The endotoxin concentration was significantly higher one day after surgery (2.15+/-1.36 pg/ml) than that before surgery (1.27+/-1.00 pg/mL), (p<0.05). The mean endotoxin concentration in the patients after early oral feeding (0.74+/-0.74 pg/ml) was significantly lower than that in the patients who could not eat (1.58+/-0.48 pg/ml). CONCLUSIONS: A low concentration of systemic endotoxins can be observed after surgery for abdominal aortic aneurysm, and early oral feeding prevented this elevation.
BACKGROUND:Endotoxemia after major vascular surgery has been suggested to be caused by the passage of bacterial endotoxins through the gut. Early enteral feeding has been reported to prevent bacterial translocation. Therefore, we investigated the incidence of endotoxemia in 12 patients with normal liver function after elective surgery for abdominal aortic aneurysm. METHODS: Blood samples were taken from the brachial vein of each patient before surgery, 1 day after surgery, and 3 days after surgery. The endotoxin concentration was measured using a chromogenic endotoxin-specific assay. RESULTS: The endotoxin concentration was significantly higher one day after surgery (2.15+/-1.36 pg/ml) than that before surgery (1.27+/-1.00 pg/mL), (p<0.05). The mean endotoxin concentration in the patients after early oral feeding (0.74+/-0.74 pg/ml) was significantly lower than that in the patients who could not eat (1.58+/-0.48 pg/ml). CONCLUSIONS: A low concentration of systemic endotoxins can be observed after surgery for abdominal aortic aneurysm, and early oral feeding prevented this elevation.
Authors: Jörn Adolphs; Diego K Schmidt; Ines Korsukewitz; Britta Kamin; Helmut Habazettl; Michael Schäfer; Martin Welte Journal: Intensive Care Med Date: 2004-08-26 Impact factor: 17.440