Peri-operative endothelial dysfunction in patients undergoing minor abdominal surgery: An observational study.
Eur J Anaesthesiol
; 36(2): 130-134, 2019 02.
Article
em En
| MEDLINE
| ID: mdl-30543557
ABSTRACT
BACKGROUND:
Myocardial injury after noncardiac surgery is common and associated with major adverse cardiac events. Surgery induces acute endothelial dysfunction, which might be central in the pathophysiology of myocardial injury; however, the relationship between surgical stress and endothelial function remains incompletely understood.OBJECTIVES:
This study aimed to assess the acute peri-operative changes in endothelial function after minor elective abdominal surgery.DESIGN:
A prospective, observational, single-centre study.SETTING:
A university hospital from February 2016 to January 2017. PATIENTS Sixty patients undergoing elective minor abdominal surgery. MAIN OUTCOMEMEASURES:
The change in endothelial function, expressed as the reactive hyperaemia index (RHI), was assessed by non-invasive digital pulse tonometry. RHI, biomarkers of nitric oxide bioavailability and oxidative stress were assessed prior to and 4âh after surgery.RESULTS:
RHI decreased significantly from 1.93 [95% confidence interval (95% CI 1.78 to 2.09)] before surgery to 1.76 (95% CI 1.64 to 1.90), Pâ=â0.03, after surgery. The nitric oxide production, L-arginine/asymmetric dimethylarginine, decreased significantly from a ratio of 213.39 (95% CI 188.76 to 241.2) to a ratio of 193.3 (95% CI 171.82 to 217.54), Pâ=â0.03. Plasma biopterins increased significantly after surgery, while the ratio between tetrahydrobiopterin and dihydrobiopterin was unchanged. Total ascorbic acid decreased significantly after surgery (Pâ<â0.001), while its oxidation ratio was unchanged.CONCLUSION:
Elective minor abdominal surgery impaired systemic endothelial function early after surgery. TRIAL REGISTRATION Clinicaltrials.gov identifier NCT02690233.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
/
Endotélio Vascular
/
Abdome
Tipo de estudo:
Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article