Ischemia-modified albumin and adenosine plasma concentrations are associated with severe systemic inflammatory response syndrome after cardiopulmonary bypass

Abstract Purpose Severe systemic inflammatory response syndrome (SIRS) occurring after cardiopulmonary bypass (CPB) is a common cause of mortality during cardiac surgery. These syndromes are characterized by vasoplegia and ischemia-reperfusion phenomenom. Adenosine is a strong endogenous vasodilatin...

Full description

Saved in:
Bibliographic Details
Published in:Journal of critical care 2013-10, Vol.28 (5), p.747-755
Main Authors: Nee, Laetitia, MD, Giorgi, Roch, MD, PhD, Garibaldi, Vlad, MD, Bruzzese, Laurie, Blayac, Dorothée, MD, Fromonot, Julien, Kipson, Nathalie, Bellezza, Maurice, MD, Lejeune, Pierre Jean, Guieu, Régis, MD, PhD, Kerbaul, François, MD, PhD
Format: Article
Language:English
Subjects:
Adenosine
Adenosine - blood
Aged
Albumins - metabolism
Anesthesia - methods
Biomarkers - blood
Cardiopulmonary Bypass - adverse effects
Coronary Disease - surgery
Critical Care
Female
Heart attacks
Hemodynamics - physiology
Humans
Ischemia-modified albumin
Male
Middle Aged
Mortality
Plasma
Prospective Studies
SIRS
Systemic Inflammatory Response Syndrome - blood
Systemic Inflammatory Response Syndrome - etiology
Systemic Inflammatory Response Syndrome - physiopathology
Systemic Inflammatory Response Syndrome - therapy
Veins & arteries
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Purpose Severe systemic inflammatory response syndrome (SIRS) occurring after cardiopulmonary bypass (CPB) is a common cause of mortality during cardiac surgery. These syndromes are characterized by vasoplegia and ischemia-reperfusion phenomenom. Adenosine is a strong endogenous vasodilating agent, which may be involved in blood pressure failure during CPB induced by severe SIRS. Ischemia-modified albumin (IMA) is considered as a sensitive marker of tissue ischemia. We examined whether the IMA or adenosine plasma concentrations (APCs) change during a severe SIRS-induced blood pressure failure during CPB. Materials and Methods Plasma concentration and IMA (median [range]) were measured before, during, and after surgery in 86 patients who underwent coronary revascularization under CBP and were correlated to postoperative clinical course. Results Preoperative APC values (1.45 [0.52-2.11] μ mol L − 1 vs 0.36 [0.12-0.66] μ mol L − 1 ) and IMA (144 [91-198] IU mL − 1 vs 109 [61-183] U mL − 1 ) were significantly increased in patients presenting postoperative severe SIRS. Mean durations of mechanical ventilation, stay in the intensive care unit, and requirement of vasoactive drugs were significantly higher in patients with higher APC and IMA, but APC was the best predictive marker a postoperative severe. Conclusions Adenosine plasma concentration and IMA concentration are associated with postoperative severe SIRS after CPB.
ISSN:0883-9441
1557-8615
DOI:10.1016/j.jcrc.2013.02.014