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Elective AAA Repair (elective aaa + repair)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Cytokine gene polymorphisms and the inflammatory response to abdominal aortic aneurysm repair,

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 9 2003
M. J. Bown
Background: Cytokines are key mediators of the inflammatory response to surgery and polymorphic sites in their genes have been shown to affect cytokine production in vitro. The aim of this study was to determine whether cytokine gene polymorphisms affect cytokine production in vivo in patients undergoing abdominal aortic aneurysm (AAA) repair. Methods: One hundred patients admitted for elective AAA repair had plasma levels of interleukin (IL) 1,, IL-6, IL-10 and tumour necrosis factor (TNF) , measured at induction of anaesthesia and 24 h after operation. Genotypes for each patient were determined using induced heteroduplex genotyping for the following loci: IL-1, + 3953, IL-6 , 174, IL-10 , 1082/,592 and TNF-, , 308. Results: Patients with an IL-10 , 1082 A allele had a significantly higher IL-10 response to surgery than those without an A allele (P = 0·030) and there was also a significant difference in IL-10 response between patients with IL-10 , 1082 AA genotypes and those with GG genotypes (P = 0·030). Conclusion: Elective AAA repair results in a measurable cytokine response. In this study the magnitude of this response was not affected by the individual patient's cytokine gene polymorphisms. Copyright © 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source]

Early discharge following abdominal aortic aneurysm repair: Impact on patients and caregivers

RESEARCH IN NURSING & HEALTH, Issue 5 2002
Mildred A. Jones
Abstract Although early discharge is common place, little is known about its impact after abdominal aortic aneurysm (AAA) surgery. We sought to prospectively describe patient outcomes and caregiving experience after early discharge following elective AAA repair using a standard or endovascular grafting system (EGS) procedure. Fifty-one patients (Standard, n=25; EGS, n=26) completed questionnaires on symptoms and health-related quality of life (HRQoL) while hospitalized and 1, 4, and 8 weeks after discharge. Data were also obtained from caregivers. HRQoL decreased at Week 1 in both groups but returned to near baseline by Week 8. Standard AAA patients experienced more symptoms and activity limitations, but these were concentrated in Week 1. Most caregivers were positive about caregiving and required no additional resources. Findings suggest that most patients who undergo early discharge following elective AAA surgery experience few problems. Those problems that occur concentrate in the week following discharge, suggesting the need for closer monitoring at this time. © 2002 Wiley Periodicals, Inc. Res Nurs Health 25:345,356, 2002 [source]

Cytokine gene polymorphisms and the inflammatory response to abdominal aortic aneurysm repair,

Randomized controlled trial of acute normovolaemic haemodilution in aortic aneurysm repair

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 4 2001
L. Wolowczyk
Background: Previous studies have suggested that acute normovolaemic haemodilution (ANH) reduces the need for heterologous blood transfusion in abdominal aortic aneurysm (AAA) surgery and may thus improve postoperative outcome by reducing the systemic inflammatory response. Controlled studies are lacking. The aim of this randomized controlled trial was to evaluate the effects of ANH on the systemic inflammatory response, clinical outcome and use of bank blood after AAA repair. Methods: Patients undergoing elective AAA repair were randomized to ANH (n = 16) or control (n = 18) groups. Intraoperative cell salvage and heterologous blood were used in both groups according to predetermined transfusion triggers. Inflammatory markers in serum and urine were measured to assess the acute-phase response. Clinical outcome was determined using mortality, morbidity and the incidence of the systemic inflammatory response syndrome (SIRS). Results: There was no difference between the ANH and control group in serial measurements of median (range) white cell count (maximum at 2 days after operation: 11·9 (7·7,21·4) versus 10·3 (7·8,20·6) × 109 l,1; P = 0·25), serum C-reactive protein level (maximum at 3 days: 150 (1,274) versus 169 (7,238) mg ml,1; P = 0·76), interleukin 6 level (maximum at 6 h: 142 (32,793) versus 105 (29,509) pg ml,1; P = 0·89), total antioxidant capacity (lowest at 1 h: 0·83 (0·67,1·22) versus 0·83 (0·68,1·23) mmol l,1; P = 0·45) or urinary albumin/creatinine ratio (maximum at 30 min after clamp release: 41 (2,923) versus 124 (4,376) mg ml,1; P = 0·10). SIRS was observed in ten of 16 patients having ANH and in 11 of 18 control patients (P = 0·99). There was no significant difference in mortality and morbidity between the groups. Similarly, there was no difference in median (range) blood loss (ANH 1800 (400,12 000) ml versus control 1600 (500,7500) ml; P = 0·55), use of cell salvage (600 (0,4740) versus 520 (0,2420) ml; P = 0·60) or heterologous blood transfusion (2 (0,32) versus 2 (0,9) units; P = 0·68). Conclusion: In the setting of a randomized controlled trial ANH added no additional benefit, when used in combination with cell salvage, in reducing the requirements for heterologous blood transfusion, and made no impact on systemic inflammatory response and clinical outcome after AAA repair. © 2001 British Journal of Surgery Society Ltd [source]