S. Inoue et al., Cerebral production of adrenomedullin after hypothermic cardiopulmonary bypass in adult cardiac surgical patients, ANESTH ANAL, 88(5), 1999, pp. 1030-1035
Citations number
24
Categorie Soggetti
Aneshtesia & Intensive Care","Medical Research Diagnosis & Treatment
Adrenomedullin is a potent vasodilatory peptide originally identified in hu
man pheochromocytoma. Plasma adrenomedullin increases during and after card
iopulmonary bypass (CPB). However, the site at which production of adrenome
dullin is augmented has not been identified. In the present study, we exami
ned the contribution of the cerebral vasculature to the production of adren
omedullin in patients before, during, and after CPB. Ten patients undergoin
g coronary artery bypass grafting with mild hypothermic CPB were studied. C
erebral blood flow was measured using the Kety-Schmidt method before, durin
g, and after CPB. Plasma adrenomedullin concentrations from radial artery a
nd internal jugular bulb blood were measured by radioimmunoassay, and cereb
ral adrenomedullin production was evaluated. Adrenomedullin production in t
he cerebral vasculature was significantly enhanced after CPB and correlated
with aortic cross-clamping time. The cerebral adrenomedullin production ma
y contribute to the increased plasma level of adrenomedullin after CPB. Imp
lications: Plasma adrenomedullin has been reported to Increase in humans af
ter cardiac surgery involving cardiopulmonary bypass. In this study, we dem
onstrated that cerebral adrenomedullin production may contribute to the inc
reased plasma level of adrenomedullin after cardiopulmonary bypass.