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CARDIOVASCULAR ANESTHESIA

Heparin Induces Release of Phospholipase A₂ into the Splanchnic Circulation

Hartmut Kern, MD^*, Wolfram Johnen, MD^*, Jan Braun, MD^*, Bettina Frey^*, Bernd Rüstow, PhD, Wolfgang J. Kox, MD, PhD, FRCP^*, and Michael Schlame, MD, PhD, DEAA^*

Departments of *Anesthesiology and Intensive Care Medicine and Neonatology, University Hospital Charité, Humboldt University, Berlin, Germany

Address correspondence and reprint requests to Michael Schlame, MD, PhD, DEAA, Department of Anesthesiology and Intensive Care Medicine, University Hospital Charité, 10117 Berlin, Germany, Schumannstr. 20/21. Address e-mail to schlamem{at}hss.edu

Cardiopulmonary bypass results in increased plasma activity of phospholipase A₂ (PLA₂) that appears to be caused by the administration of heparin. High PLA₂ activity may be responsible for increased production of eicosanoids and, thus, may be implicated in various pathophysiologic events associated with cardiac surgery. To investigate the site of PLA₂ secretion, blood samples were simultaneously collected from the radial artery, the pulmonary artery, and the hepatic vein at 2, 4, 6, and 20 min after systemic heparinization (350 U/kg). Within 2 min of the heparin injection, plasma activity of PLA₂ increased 4- to 9-fold and remained so for at least 20 min. Two minutes after the heparin injection, PLA₂ was significantly higher in the hepatic vein than in the radial artery (P < 0.01). No such difference was detected between pulmonary and radial arteries. When heparin was added to blood samples in vitro (5–100 U/mL), plasma activity of PLA₂ did not increase, which suggests that the enzyme was not secreted by blood cells.

Implications: Heparin, given in the dosage required for cardiopulmonary bypass, caused release of phospholipase A₂ into the splanchnic circulation.

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Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999