Cardiothoracic & vascular anesthesia
Impaired endotoxin inactivation, rather than gut translocation, is associated with organ injury in cardiac surgery with cardiopulmonary bypass: An ancilliary analysis of a randomised control trial
Authors' conclusion
The capacity of individuals to inactivate endotoxin rather than raw endotoxin mass (i.e. Quantity) seemed to be a determinant of endotoxin noxious effect in cardiac surgery and CBP. Haemo-adsorption was not associated with a reduction of endotoxin plasma mass or activity in patients with cardiac surgery under CPB.
Study context
- Population
- Adults scheduled for cardiac surgery under cardiopulmonary bypass (CPB) with expected CPB time >90 min, Amiens University Hospital295 samples analysed
- Participants
- 66 adults
- Comparison
- Intra-operative haemo-adsorption vs standard of care during CPB
- Primary endpoint
- Endotoxin activity
Methodological detailssingle-centre
- Single-centre
Primary result
As reported in the abstract
Endotoxin activity and mass · before surgery, end of CPB, 6, 24 and 48 h after surgery
- After CPB, reduction in endotoxin mass with relative increase in endotoxin activity
- Endotoxin plasma concentration and activity not lower with haemo-adsorption
Further findings
Associations of high postoperative endotoxin activity
- Associated with intra-operative dobutamine requirement, increased postoperative inflammatory biomarkers and organ injury
Original publication
Impaired endotoxin inactivation, rather than gut translocation, is associated with organ injury in cardiac surgery with cardiopulmonary bypass: An ancilliary analysis of a randomised control trial. Eur J Anaesthesiol. Published 13 January 2026. doi:10.
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