Author:
Mossanen Jana C.,Jansen Tobias U.,Pracht Jessica,Liepelt Anke,Buendgens Lukas,Stoppe Christian,Goetzenich Andreas,Simon Tim-Philipp,Autschbach Rüdiger,Marx Gernot,Tacke Frank
Abstract
AbstractElective cardiac surgery has low procedural complications. However, about 40% of patients develop extracardiac complications including delirium and acute kidney injury. We hypothesized that inflammatory processes and immune cell activation might be associated with these complications. We therefore prospectively included 104 patients undergoing cardiac surgery in our study. We assessed peripheral blood leukocyte populations by flow cytometry and circulating cytokines before operation, after surgery and at days one and four post-operatively. Patients undergoing cardiac surgery showed significantly elevated leukocytes and neutrophils after surgery. On the contrary, monocytes decreased after surgery and significantly increased at days 1 and 4, particularly classical (Mon1,CD14++CD16−) and intermediate (Mon2,CD14++CD16+) monocytes. While peripheral leukocyte subsets were unaltered in patients with infectious (n = 15) or cardiac complications (n = 31), post-operative leukocytes (p = 0.0016), neutrophils (p = 0.0061) and Mon2 (p = 0.0007) were clearly raised in patients developing extracardiac complications (n = 35). Using multiple logistic regression analyses, patient’s age, ICU days, number of blood transfusions and elevated post-surgery Mon2 independently predicted extracardiac complications. Our findings demonstrate that elevated Mon2 after cardiac surgery are associated with an increased risk for extracardiac complications. These findings might improve the risk estimation after cardiac operations and the role of Mon2 for inflammation in cardiac surgery.
Funder
German Research Foundation
Publisher
Springer Science and Business Media LLC
Reference37 articles.
1. Gopaldas, R. R. et al. Outcomes of concomitant aortic valve replacement and coronary artery bypass grafting at teaching hospitals versus nonteaching hospitals. The Journal of thoracic and cardiovascular surgery 143, 648–655, https://doi.org/10.1016/j.jtcvs.2011.04.041 (2012).
2. Brown, C. H. Delirium in the cardiac surgical ICU. Current opinion in anaesthesiology 27, 117–122, https://doi.org/10.1097/ACO.0000000000000061 (2014).
3. Mariscalco, G., Lorusso, R., Dominici, C., Renzulli, A. & Sala, A. Acute kidney injury: a relevant complication after cardiac surgery. The Annals of thoracic surgery 92, 1539–1547, https://doi.org/10.1016/j.athoracsur.2011.04.123 (2011).
4. Day, J. R. & Taylor, K. M. The systemic inflammatory response syndrome and cardiopulmonary bypass. International journal of surgery 3, 129–140, https://doi.org/10.1016/j.ijsu.2005.04.002 (2005).
5. Landis, R. C. et al. Attenuating the Systemic Inflammatory Response to Adult Cardiopulmonary Bypass: A Critical Review of the Evidence Base. The journal of extra-corporeal technology 46, 197–211 (2014).
Cited by
18 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献