Critical Care

, 10:P236 | Cite as

Long-term alcoholic patients have decreased perioperative cAMP levels

  • H Schoenfeld
  • R Franke
  • C von Heymann
  • U Doepfmer
  • A Blaicher
  • S Ziemer
  • C Spies
Poster presentation
  • 642 Downloads

Keywords

Serotonin Platelet Aggregation Alcohol Abuse Guanosine cAMP Level 

Background

Patients with chronic alcohol misuse have an increased risk of postoperative bleeding complications compared with non-alcoholic individuals [1]. Serotonin increases [2], and cAMP and cyclic guanosine monophosphate (cGMP) decrease, platelet aggregation [3]. The aim of our study was to examine platelet-rich plasma levels of the mentioned substances in long-term alcoholic patients undergoing surgery.

Methods

We included 33 consecutive patients with chronic alcohol misuse scheduled for tumor resections of the upper digestive tract and postoperative intensive care. We defined long-term alcoholic patients as having a daily alcohol intake of at least 60 g and fulfilling the DSM-IV criteria of the American Psychiatric Association for alcohol abuse or dependence. Blood samples were collected before and 1 day after surgery. Serotonin was measured by ELISA, cAMP and cGMP by radioimmunoassay. Additionally, we measured standard coagulation tests and determined platelet aggregation induced by ADP, collagen, epinephrine and ristocetin before and after surgery. Statistics: Mann-Whitney U test.

Results

Basic patient characteristics and platelet aggregation responses induced by the mentioned agonists did not significantly differ. Data are presented in Table 1.
Table 1

abstract P236

Parameter

Alcoholics

Nonalcoholics

P value

cAMP preoperatively (nmol/l)

1.8 (1.6–2.6)

3.2 (2.2–5.3)

<0.01

cAMP postoperatively (nmol/l)

1.8 (1.5–2.3)

2.7 (2.1–3.9)

0.03

cGMP preoperatively (nmol/l)

4.0 (2.3–5.8)

5.6 (1.6–14.4)

0.77

cGMP postoperatively (nmol/l)

2.9 (2.3–7.8)

3.7 (1.4–9.3)

0.94

Serotonin preoperatively (ng/109 platelets)

381 (194–573)

386 (180–905)

0.98

Serotonin postoperatively (ng/109 platelets)

288 (193–380)

460 (225–923)

0.10

Data presented as median (25th–75th quartiles).

Conclusion

In contrast to previous studies, there were no significantly altered aggregation responses in long-term alcoholic patients. A possible explanation might be the decreased inhibition through diminished cAMP levels. Our findings may suggest that cGMP and serotonin do not influence the perioperative hemostasis.

References

  1. 1.
    Spies CD: Anesth Analg. 1999, 88: 946-954. 10.1097/00000539-199904000-00050PubMedGoogle Scholar
  2. 2.
    Kereveur A: Arterioscler Thromb Vasc Biol. 2000, 20: 2233-2239.CrossRefPubMedGoogle Scholar
  3. 3.
    Qi R: J Cardiovasc Pharmacol. 1996, 28: 215-222. 10.1097/00005344-199608000-00006CrossRefPubMedGoogle Scholar

Copyright information

© BioMed Central Ltd 2006

Authors and Affiliations

  • H Schoenfeld
    • 1
  • R Franke
    • 1
  • C von Heymann
    • 1
  • U Doepfmer
    • 1
  • A Blaicher
    • 2
  • S Ziemer
    • 1
  • C Spies
    • 1
  1. 1.Charite Campus MitteCharite-Universitaetsmedizin BerlinBerlinGermany
  2. 2.Medical University of ViennaViennaAustria

Personalised recommendations