ENDOTOXEMIA AND POSTOPERATIVE HYPERMETABOLISM IN CORONARY-ARTERY BYPASS-SURGERY - THE ROLE OF KETANSERIN

In a randomized, double-blind clinical study in 29 patients undergoing elective coronary artery surgery, we assessed the role of ketanserin, an inhibitor of serotonin-induced vasoconstriction and weak alpha(1) sympathetic blocker, in reducing endotoxaemia and postoperative hyperm etabolism. Male patients without major organ dysfunction were allocate d randomly to receive either ketanserin or placebo. Hypermetabolism wa s defined as an increase in oxygen consumption in the early postoperat ive hours (Delta V over dot (O2)). Circulating endotoxin (P=0.04) and postoperative Delta V over dot (O2) (P=0.03) were lower in the ketanse rin patients. Endotoxaemia was associated also with low vascular filli ng. From these preliminary results we conclude that treatment with ket anserin during cardiac surgery may reduce but not abolish endotoxaemia and postoperative hypermetabolism.