Procalcitonin following cardiopulmonary bypass. Origin from hepatosplanchnicus?

Procalcitonin (PCT) is an inflammatory peptide of still unknown origin. In this study we investigated a potential source for circulating PCT in patien ts undergoing coronary artery bypass grafting. Methods: To determine PCT concentrations, arterial, liver-venous and mixed- venous blood samples were collected time matched perioperatively in 20 pati ents scheduled for cardiac surgery using cardiopulmonary bypass (CPB). Results: PCT concentrations significantly increased 4 hours postoperatively compared to baseline values (0,74+/-0,45 vs.0,16+/-0,04 ng/ml). The highes t concentrations were measured 18 hours postoperatively (1,44+/-1,01 ng/ml) . PCT concentrations in liver venous samples were significantly higher (1,6 7+/-1,29 ng/ml) than in time matched collected arterial samples (1,44+/-1,0 1 ng/ml). Conclusion: These results provide evidence, that hepatosplanchnicus is a so urce for PCT synthesis in patients following CPB. The mechanism of PCT indu ction remains unclear. A loss of gut mucosal barrier function with transloc ation of endotoxins and the inflammatory response with release of cytokines following cardiopulmonary bypass has to be discussed.