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British Journal of Anaesthesia, Vol 77, Issue 4 473-479, Copyright © 1996 by The Board of Management and Trustees of the British Journal of Anaesthesia

CLINICAL INVESTIGATIONS

Endotoxaemia and postoperative hypermetabolism in coronary artery bypass surgery: the role of ketanserin

HMO. Straaten, PGM. Jansen, H. te Velthuis, C. P. Stoutenbeek, D. F. Zandstra, SJH. van Deventer, A. Sturk, CRH. Wildevuur and L. Eijsman
Department of Intensive Care, Onze Lieve Vrouwe Gasthuis, PO Box 95500, 1090 HM Amsterdam, The Netherlands; Centre for Cardiopulmonary Surgery, University Hospital "Vrije Universiteit", PO Box 7057, 1007 MB Amsterdam; Department of Pathophysiology of Plasmatic Proteins, Central Laboratory of the Netherlands Red Cross Blood Transfusion Service, Amsterdam; Department of Intensive Care, Academic Medical Centre, Amsterdam; Centre for Haemostasis, Thrombosis and Atherosclerosis Research, Academic Medical Centre, Amsterdam; Department of Clinical Chemistry, University Hospital, Leiden

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 hypermetabolism. Male patients without major organ dysfunction were allocated randomly to receive either ketanserin or placebo. Hypermetabolism was defined as an increase in oxygen consumption in the early postoperative hours (delta Vo2). Circulating endotoxin (P = 0.04) and postoperative delta Vo2 (P = 0.03) were lower in the ketanserin patients. Endotoxaemia was associated also with low vascular filling. From these preliminary results we conclude that treatment with ketanserin during cardiac surgery may reduce but not abolish endotoxaemia and postoperative hypermetabolism.
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