Heparin induces release of phospholipase A(2) into the splanchnic circulation.

Kern, H; Johnen, W; Braun, J; Frey, B; Rüstow, B; Kox, W J; Schlame, M · Anesth Analg · 2000

prospective_cohort · Level II

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Abstract

Cardiopulmonary bypass results in increased plasma activity of phospholipase A(2) (PLA(2)) that appears to be caused by the administration of heparin. High PLA(2) 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 PLA(2) 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 PLA(2) increased 4- to 9-fold and remained so for at least 20 min. Two minutes after the heparin injection, PLA(2) 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 PLA(2) did not increase, which suggests that the enzyme was not secreted by blood cells. Heparin, given in the dosage required for cardiopulmonary bypass, caused release of phospholipase A(2) into the splanchnic circulation.

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