Objective
Experimental 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.
Design
Prospective, observational, clinical cohort study.
Setting
Operating room (OR) and intensive care unit (ICU) of a university hospital.
Patients
One 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.
Measurements
Baseline apoCI, apoCIII, total cholesterol and triglyceride levels, and perioperative endotoxin and TNF-α levels were determined.
Results
High 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.
Conclusion
High plasma apoCI is positively related to proinflammatory response in patients experiencing endotoxemia and confirms the
observations in animal models.
Keywords Cardiopulmonary bypass - SIRS - Endotoxemia - Endotoxin - ApoCI - TNF-α