Changes in plasma granulocyte elastase, myeloperoxidase and fibronectin during and after open heart surgery

Arterial and pulmonary arterial levels of plasma granulocyte elastase, myeloperoxidase and fibronectin were measured during and after cardiac surgery by using a bubble oxygenator. Granulocyte elastase-proteinase inhibitor and myeloperoxidase increased significantly from the end of cardiopulmonary bypass to the first postoperative day. The levels of granulocyte elastase-proteinase inhibitor and myeloperoxidase correlated with the perfusion time with cardiopulmonary bypass, but did not correlate with respiratory index except correlation of the level of arterial myeloperoxidase with respiratory index on the first postoperative day. We speculate that microvascular leukostasis occurs after cardiopulmonary bypass on account of the differences of the level of myeloperoxidase between arterial and pulmonary arterial blood. Plasma fibronectin decreased slightly during operation and on the first postoperative day.