Influence of surgery on serum concentrations of hyaluronan

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Abstract
Objective To investigate the changes in serum hyaluronan concentrations in response to surgery. Design A prospective case series evaluating serum hyaluronan concentrations before, during, and after surgery. Setting Operating room and recovery room of a university hospital. Patients Twelve consecutive patients undergoing vascular surgery because of arterial insufficiency of the lower extremities. Measurements and Main Results Serum hyaluronan concentrations were measured before and after induction of anesthesia and before, during, and after surgery. Routine chemical analyses of blood samples were made before and after surgery. Blood loss and fluid volumes infused were registered. Mean serum hyaluronan concentrations increased from baseline 25 ± 10 (SD) to 36 ± 15 μg/L (p < .05) during surgery, and increased further at 1 hr after the end of surgery to 52 ± 38 μg/L (p < .001 compared with baseline), but had decreased nearly to baseline levels at 2 hrs postoperatively. A positive correlation was seen between peak hyaluronan concentrations and baseline serum hyaluronan levels (r2 = .73; p < .001), but no strong relationship was seen between serum hyaluronan concentrations and other parameters studied. Conclusions Surgery is accompanied by a small increase in serum hyaluronan concentrations in humans. The major increase is seen in the postoperative period, and is probably due to increased influx of interstitial hyaluronan when the returning muscular tone activates lymph flow. (Crit Care Med 1994; 22:810–814)

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