Amar D, Fleisher M, Leung D H, Zhang H, Ginsburg I, Roistacher N
Department of Anesthesiology and Critical Care Medicine, Memorial Sloan-Kettering Cancer Center and Cornell University Medical College, New York, NY 10021, USA.
J Cardiothorac Vasc Anesth. 2000 Apr;14(2):140-3. doi: 10.1016/s1053-0770(00)90007-7.
To determine whether greater changes in plasma endothelin-1 (ET-1) concentrations and right ventricular systolic pressure occur after major thoracic surgery than after major abdominal operations.
Prospective study.
University hospital.
Patients undergoing elective thoracotomies (n = 12) or laparotomies (n = 10).
ET-1 was measured from blood obtained before anesthesia and again on postoperative days 1, 2, 3, and 5 (or 6). Transthoracic echocardiography was performed before surgery and on postoperative day 2 to evaluate right-sided heart function.
After abdominal and thoracic surgery, systemic and estimated pulmonary vascular pressures were normal in both groups and unaffected by surgery. Plasma ET-1 concentrations decreased from baseline values during the first postoperative week with no differences between the groups.
In patients without organic heart disease, plasma ET-1 levels do not increase in response to major abdominal or thoracic surgery. Whether or not plasma ET-1 concentrations are elevated in patients developing clinically significant postoperative pulmonary hypertension requires further study.
确定与腹部大手术后相比，胸部大手术后血浆内皮素-1（ET-1）浓度和右心室收缩压的变化是否更大。
前瞻性研究。
大学医院。
接受择期开胸手术（n = 12）或剖腹手术（n = 10）的患者。
在麻醉前采集的血液中测量ET-1，并在术后第1、2、3和5天（或第6天）再次测量。术前和术后第2天进行经胸超声心动图检查，以评估右心功能。
腹部和胸部手术后，两组的全身和估计的肺血管压力均正常，且不受手术影响。术后第一周血浆ET-1浓度从基线值下降，两组之间无差异。
在无器质性心脏病的患者中，腹部或胸部大手术不会使血浆ET-1水平升高。临床上出现显著术后肺动脉高压的患者血浆ET-1浓度是否升高需要进一步研究。
