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154. Clinical Significance of Micronutrient Supplementation in Critically Ill COVID-19 Patients with Severe ARDS

Author

Notz, Quirin, primary, Herrmann, Johannes, additional, Schlesinger, Tobias, additional, Helmer, Philipp, additional, Sudowe, Stephan, additional, Sun, Qian, additional, Hackler, Julian, additional, Roeder, Daniel, additional, Lotz, Christopher, additional, Meybohm, Patrick, additional, Kranke, Peter, additional, Schomburg, Lutz, additional, and Stoppe, Christian, additional

Published
2021
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157. The initial validation of a novel outcome measure in severe burns- the Persistent Organ Dysfunction +Death: Results from a multicenter evaluation

Author

Stoppe, Christian, primary, Hill, Aileen, additional, Day, Andrew G, additional, Kristof, Arnold S, additional, Hundeshagen, Gabriel, additional, Kneser, Ulrich, additional, Beier, Justus, additional, Lumenta, David, additional, Kim, Bong-Sung, additional, Plock, Jan, additional, Collins, Declan P, additional, Gille, Jochen, additional, Jiang, Xuran, additional, and Heyland, Daren K, additional

Published
2021
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158. Macrophage Migration Inhibitory Factor—An Innovative Indicator for Free Flap Ischemia after Microsurgical Reconstruction

Author

Megas, Ioannis-Fivos, primary, Simons, David, additional, Kim, Bong-Sung, additional, Stoppe, Christian, additional, Piatkowski, Andrzej, additional, Fikatas, Panagiotis, additional, Fuchs, Paul Christian, additional, Bastiaanse, Jacqueline, additional, Pallua, Norbert, additional, Bernhagen, Jürgen, additional, and Grieb, Gerrit, additional

Published
2021
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159. The impact of the SARS-CoV-2 pandemic on the ongoing prospective, international, multicentre observational study assessing the preoperative anaemia prevalence in surgical patients (ALICE-trial)

Author

Judd, L L, Baron, D M, Bisbe, E, Lasocki, S, Metnitz, P, Poschmann, M, Raobaikady, R, Reichmayr, M, Spahn, Donat R, Stoppe, Christian, Zacharowski, K, Choorapoikayil, Suma, Meybohm, Patrick, and University of Zurich

Subjects
10216 Institute of Anesthesiology, 610 Medicine & health
Published
2021

162. The inhibition of Macrophage Migration Inhibitory Factor by ISO-1 attenuates trauma-induced multi organ dysfunction in rats

Author

Martin, Lukas, primary, Patel, Nikita Mayur, additional, Yamada, Noriaki, additional, Borges Oliveira, Filipe Rodolfo Moreira, additional, Stiehler, Lara, additional, Zechendorf, Elisabeth, additional, Hinkelmann, Daniel, additional, Kraemer, Sandra, additional, Stoppe, Christian, additional, Collino, Massimo, additional, Collotta, Debora, additional, Alves, Gustavo Ferreira, additional, Ramos, Hanna Pillmann, additional, Sordi, Regina, additional, Marzi, Ingo, additional, Relja, Borna, additional, Marx, Gernot, additional, and Thiemermann, Christoph, additional

Published
2021
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163. Prognostic Value of Bioactive Adrenomedullin in Critically Ill Patients with COVID-19 in Germany: An Observational Cohort Study

Author

Simon, Tim-Philipp, primary, Stoppe, Christian, additional, Breuer, Thomas, additional, Stiehler, Lara, additional, Dreher, Michael, additional, Kersten, Alexander, additional, Kluge, Stefan, additional, Karakas, Mahir, additional, Zechendorf, Elisabeth, additional, Marx, Gernot, additional, and Martin, Lukas, additional

Published
2021
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164. Macrophage Migration Inhibitory Factor (MIF) Plasma Concentration in Critically Ill COVID-19 Patients: A Prospective Observational Study

Author

Bleilevens, Christian, primary, Soppert, Josefin, additional, Hoffmann, Adrian, additional, Breuer, Thomas, additional, Bernhagen, Jürgen, additional, Martin, Lukas, additional, Stiehler, Lara, additional, Marx, Gernot, additional, Dreher, Michael, additional, Stoppe, Christian, additional, and Simon, Tim-Philipp, additional

Published
2021
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166. Impact of malnutrition on survival in adult patients after elective cardiac surgery: Long-term follow up data

Author

Efremov, Sergey M., primary, Ionova, Tatiana I., additional, Nikitina, Tatiana P., additional, Vedernikov, Pavel E., additional, Dzhumatov, Timur A., additional, Ovchinnikov, Timofey S., additional, Rashidov, Abduvahhob A., additional, Khomenko, Alexandr E, additional, Stoppe, Christian, additional, Heyland, Daren K., additional, and Lomivorotov, Vladimir V., additional

Published
2021
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167. Nutritional therapy among burn injured patients in the critical care setting: An international multicenter observational study

Author

Stoppe, Christian, Chourdakis, Michael, Bouras, Emmanouil, Grammatikopoulou, Maria G., Shields, Beth A., Rousseau, Anne-Françoise, Moiemen, Naiem, and Heyland, Daren K.

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Background: Severely burned patients pose a number of clinical challenges for medical doctors and dietitians to achieve optimal nutrition practice. The objective of this study was to describe nutrition practices for burn patients in intensive care units (ICU) relatively to the most recent ESPEN and [for full text, please go to the a.m. URL], 38. Jahrestagung der Deutschsprachigen Arbeitsgemeinschaft für Verbrennungsbehandlung (DAV 2020)

Published
2020

168. The Macrophage Migration Inhibitory Factor (MIF) promoter polymorphisms (rs3063368, rs755622) predict acute kidney injury and death after cardiac surgery

Author

RIPHeart Study Collaborators, Averdunk, Luisa, Bernhagen, Jürgen, Fehnle, Karl, Surowy, Harald, Lüdecke, Hermann-Josef, Mucha, Sören, Meybohm, Patrick, Wieczorek, Dagmar, Leng, Lin, Marx, Gernot, Leaf, David E., Zarbock, Alexander, Zacharowski, Kai, Bucala, Richard, Stoppe, Christian, RIPHeart Study Collaborators, Averdunk, Luisa, Bernhagen, Jürgen, Fehnle, Karl, Surowy, Harald, Lüdecke, Hermann-Josef, Mucha, Sören, Meybohm, Patrick, Wieczorek, Dagmar, Leng, Lin, Marx, Gernot, Leaf, David E., Zarbock, Alexander, Zacharowski, Kai, Bucala, Richard, and Stoppe, Christian

Abstract

Background: Macrophage Migration Inhibitory Factor (MIF) is highly elevated after cardiac surgery and impacts the postoperative inflammation. The aim of this study was to analyze whether the polymorphisms CATT5–7 (rs5844572/rs3063368,“-794”) and G>C single-nucleotide polymorphism (rs755622,-173) in the MIF gene promoter are related to postoperative outcome. Methods: In 1116 patients undergoing cardiac surgery, the MIF gene polymorphisms were analyzed and serum MIF was measured by ELISA in 100 patients. Results: Patients with at least one extended repeat allele (CATT7) had a significantly higher risk of acute kidney injury (AKI) compared to others (23% vs. 13%; OR 2.01 (1.40–2.88), p = 0.0001). Carriers of CATT7 were also at higher risk of death (1.8% vs. 0.4%; OR 5.12 (0.99–33.14), p = 0.026). The GC genotype was associated with AKI (20% vs. GG/CC:13%, OR 1.71 (1.20–2.43), p = 0.003). Multivariate analyses identified CATT7 predictive for AKI (OR 2.13 (1.46–3.09), p < 0.001) and death (OR 5.58 (1.29–24.04), p = 0.021). CATT7 was associated with higher serum MIF before surgery (79.2 vs. 50.4 ng/mL, p = 0.008). Conclusion: The CATT7 allele associates with a higher risk of AKI and death after cardiac surgery, which might be related to chronically elevated serum MIF. Polymorphisms in the MIF gene may constitute a predisposition for postoperative complications and the assessment may improve risk stratification and therapeutic guidance.

Published
2020

169. Gastrointestinal dysfunction in the critically ill: a systematic scoping review and research agenda proposed by the Section of Metabolism, Endocrinology and Nutrition of the European Society of Intensive Care Medicine

Author

Reintam Blaser, Annika, Preiser, Jean-Charles, Fruhwald, Sonja, Wilmer, Alexander, Wernerman, Jan, Benstoem, Carina, Casaer, Michaël Paul, Starkopf, Joel, Van Zanten, Arthur R H, Rooyackers, Olav, Jakob, Stephan Matthias, Loudet, Cecilia C.I., Bear, Danielle D.E., Elke, Gunnar, Kott, Matthias, Lautenschläger, Ingmar, Schäper, Jörn, Gunst, Jan, Stoppe, Christian, Nobile, Leda, Fuhrmann, Valentin, Berger, Mette, Oudemans-van Straaten, Heleen Maria H H.M., Arabi, Yaseen M., Deane, A.M., Reintam Blaser, Annika, Preiser, Jean-Charles, Fruhwald, Sonja, Wilmer, Alexander, Wernerman, Jan, Benstoem, Carina, Casaer, Michaël Paul, Starkopf, Joel, Van Zanten, Arthur R H, Rooyackers, Olav, Jakob, Stephan Matthias, Loudet, Cecilia C.I., Bear, Danielle D.E., Elke, Gunnar, Kott, Matthias, Lautenschläger, Ingmar, Schäper, Jörn, Gunst, Jan, Stoppe, Christian, Nobile, Leda, Fuhrmann, Valentin, Berger, Mette, Oudemans-van Straaten, Heleen Maria H H.M., Arabi, Yaseen M., and Deane, A.M.

Abstract

BACKGROUND: Gastrointestinal (GI) dysfunction is frequent in the critically ill but can be overlooked as a result of the lack of standardization of the diagnostic and therapeutic approaches. We aimed to develop a research agenda for GI dysfunction for future research. We systematically reviewed the current knowledge on a broad range of subtopics from a specific viewpoint of GI dysfunction, highlighting the remaining areas of uncertainty and suggesting future studies. METHODS: This systematic scoping review and research agenda was conducted following successive steps: (1) identify clinically important subtopics within the field of GI function which warrant further research; (2) systematically review the literature for each subtopic using PubMed, CENTRAL and Cochrane Database of Systematic Reviews; (3) summarize evidence for each subtopic; (4) identify areas of uncertainty; (5) formulate and refine study proposals that address these subtopics; and (6) prioritize study proposals via sequential voting rounds. RESULTS: Five major themes were identified: (1) monitoring, (2) associations between GI function and outcome, (3) GI function and nutrition, (4) management of GI dysfunction and (5) pathophysiological mechanisms. Searches on 17 subtopics were performed and evidence summarized. Several areas of uncertainty were identified, six of them needing consensus process. Study proposals ranked among the first ten included: prevention and management of diarrhoea; management of upper and lower feeding intolerance, including indications for post-pyloric feeding and opioid antagonists; acute gastrointestinal injury grading as a bedside tool; the role of intra-abdominal hypertension in the development and monitoring of GI dysfunction and in the development of non-occlusive mesenteric ischaemia; and the effect of proton pump inhibitors on the microbiome in critical illness. CONCLUSIONS: Current evidence on GI dysfunction is scarce, partially due to the lack of precise definitions., SCOPUS: ar.j, info:eu-repo/semantics/published

Published
2020

174. In-hospital mortality and organ failure after open and endovascular thoraco-abdominal aortic surgery can be predicted by increased levels of circulating dipeptidyl peptidase 3

Author

Gombert, Alexander, primary, Barbati, Mohammad, additional, Kotelis, Drosos, additional, Simon, Tim-Philipp, additional, Breuer, Thomas, additional, Hartmann, Oliver, additional, Santos, Karine, additional, Bergmann, Deborah, additional, Schulte, Janin, additional, Marx, Gernot, additional, Jacobs, Michael, additional, and Stoppe, Christian, additional

Published
2020
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178. Combination of enteral and parenteral nutrition in the acute phase of critical illness: An updated systematic review and meta‐analysis.

Author

Hill, Aileen, Heyland, Daren K., Ortiz Reyes, Luis A., Laaf, Elena, Wendt, Sebastian, Elke, Gunnar, and Stoppe, Christian

Subjects
MORTALITY risk factors, LENGTH of stay in hospitals, META-analysis, SYSTEMATIC reviews, CONVALESCENCE, HEALTH outcome assessment, NUTRITIONAL requirements, INGESTION, CATASTROPHIC illness, ARTIFICIAL respiration, QUALITY of life, ENTERAL feeding, PARENTERAL feeding, ACUTE diseases
Abstract

Background: Uncertainty remains about the best route and timing of medical nutrition therapy in the acute phase of critical illness. Early combined enteral nutrition (EN) and parenteral nutrition (PN) may represent an attractive option to achieve recommended energy and protein goals in select patient groups. This meta‐analysis aims to update and summarize the current evidence. Methods: This systematic review and meta‐analysis includes randomized controlled trials (RCTs) targeting the effect of EN alone vs a combination of EN with PN in the acute phase of critical illness in adult patients. Assessed outcomes include mortality, intensive care unit (ICU) and hospital length of stay (LOS), ventilation days, infectious complications, physical recovery, and quality‐of‐life outcomes. Results: Twelve RCTs with 5543 patients were included. Treatment with a combination of EN with PN led to increased delivery of macronutrients. No statistically significant effect of a combination of EN with PN vs EN alone on any of the parameters was observed: mortality (risk ratio = 1.0; 95% CI, 0.79–1.28; P =.99), hospital LOS (mean difference, −1.44; CI, −5.59 to 2.71; P =.50), ICU LOS, and ventilation days. Trends toward improved physical outcomes were observed in two of four trials. Conclusion: A combination of EN with PN improved nutrition intake in the acute phase of critical illness in adults and was not inferior regarding the patients' outcomes. Large, adequately designed trials in select patient groups are needed to answer the question of whether this nutrition strategy has a clinically relevant treatment effect. [ABSTRACT FROM AUTHOR]

Published
2022
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181. Meeting nutritional targets of critically ill patients by combined enteral and parenteral nutrition: review and rationale for the EFFORTcombo trial

Author

Hill, Aileen, primary, Heyland, Daren K., additional, Elke, Gunnar, additional, Schaller, Stefan J., additional, Stocker, Reto, additional, Haberthür, Christoph, additional, von Loeffelholz, Christian, additional, Suchner, Ulrich, additional, Puthucheary, Zudin A., additional, Bear, Danielle E., additional, Ney, Julia, additional, Clasen, Kai C., additional, Meybohm, Patrick, additional, Lindau, Simone, additional, Laurentius, Thea, additional, and Stoppe, Christian, additional

Published
2020
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182. Ribonuclease 1 attenuates septic cardiomyopathy and cardiac apoptosis in a murine model of polymicrobial sepsis

Author

Zechendorf, Elisabeth, primary, O’Riordan, Caroline E., additional, Stiehler, Lara, additional, Wischmeyer, Natalie, additional, Chiazza, Fausto, additional, Collotta, Debora, additional, Denecke, Bernd, additional, Ernst, Sabrina, additional, Müller-Newen, Gerhard, additional, Coldewey, Sina M., additional, Wissuwa, Bianka, additional, Collino, Massimo, additional, Simon, Tim-Philipp, additional, Schuerholz, Tobias, additional, Stoppe, Christian, additional, Marx, Gernot, additional, Thiemermann, Christoph, additional, and Martin, Lukas, additional

Published
2020
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189. Elevated circulating CD14++CD16+ intermediate monocytes are independently associated with extracardiac complications after cardiac surgery

Author

Mossanen, Jana C., primary, Jansen, Tobias U., additional, Pracht, Jessica, additional, Liepelt, Anke, additional, Buendgens, Lukas, additional, Stoppe, Christian, additional, Goetzenich, Andreas, additional, Simon, Tim-Philipp, additional, Autschbach, Rüdiger, additional, Marx, Gernot, additional, and Tacke, Frank, additional

Published
2020
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191. Enhanced Recovery After Cardiac Surgery (ERAS Cardiac) Recommendations: An Important First Step—But There Is Much Work to Be Done

Author

Gregory, Alexander J., primary, Grant, Michael C., additional, Manning, Michael W., additional, Cheung, Albert T., additional, Ender, Joerg, additional, Sander, Michael, additional, Zarbock, Alexander, additional, Stoppe, Christian, additional, Meineri, Massimiliano, additional, Grocott, Hilary P., additional, Ghadimi, Kamrouz, additional, Gutsche, Jacob T., additional, Patel, Prakash A., additional, Denault, Andre, additional, Shaw, Andrew, additional, Fletcher, Nick, additional, and Levy, Jerrold H., additional

Published
2020
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193. The relevance of 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D concentration for postoperative infections and postoperative organ dysfunctions in cardiac surgery patients: The eVIDenCe study

Author

Ney, Julia, primary, Heyland, Daren K., additional, Amrein, Karin, additional, Marx, Gernot, additional, Grottke, Oliver, additional, Choudrakis, Michael, additional, Autschbach, Teresa, additional, Hill, Aileen, additional, Meybohm, Patrick, additional, Benstoem, Carina, additional, Goetzenich, Andreas, additional, Fitzner, Christina, additional, and Stoppe, Christian, additional

Published
2019
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194. Erratum: DGEM-Leitlinie: „Klinische Ernährung in der Intensivmedizin“

Author

Elke, Gunnar, additional, Hartl, Wolfgang H., additional, Kreymann, K. Georg, additional, Adolph, Michael, additional, Felbinger, Thomas W., additional, Graf, Tobias, additional, de Heer, Geraldine, additional, Heller, Axel R., additional, Kampa, Ulrich, additional, Mayer, Konstantin, additional, Muhl, Elke, additional, Niemann, Bernd, additional, Rümelin, Andreas, additional, Steiner, Stephan, additional, Stoppe, Christian, additional, Weimann, Arved, additional, and Bischoff, Stephan C., additional

Published
2019
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196. The Role of Macrophage Migration Inhibitory Factor in Remote Ischemic Conditioning Induced Hepatoprotection in a Rodent Model of Liver Transplantation

Author

Emontzpohl, Christoph, primary, Stoppe, Christian, additional, Theißen, Alexander, additional, Beckers, Christian, additional, Neumann, Ulf P., additional, Lurje, Georg, additional, Ju, Cynthia, additional, Bernhagen, Jürgen, additional, Tolba, René H., additional, and Czigany, Zoltan, additional

Published
2019
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197. Omega-6 sparing effects of parenteral lipid emulsions-an updated systematic review and meta-analysis on clinical outcomes in critically ill patients.

Author

Notz, Quirin, Lee, Zheng-Yii, Menger, Johannes, Elke, Gunnar, Hill, Aileen, Kranke, Peter, Roeder, Daniel, Lotz, Christopher, Meybohm, Patrick, Heyland, Daren K., and Stoppe, Christian

Abstract

Background: Parenteral lipid emulsions in critical care are traditionally based on soybean oil (SO) and rich in pro-inflammatory omega-6 fatty acids (FAs). Parenteral nutrition (PN) strategies with the aim of reducing omega-6 FAs may potentially decrease the morbidity and mortality in critically ill patients.Methods: A systematic search of MEDLINE, EMBASE, CINAHL and CENTRAL was conducted to identify all randomized controlled trials in critically ill patients published from inception to June 2021, which investigated clinical omega-6 sparing effects. Two independent reviewers extracted bias risk, treatment details, patient characteristics and clinical outcomes. Random effect meta-analysis was performed.Results: 1054 studies were identified in our electronic search, 136 trials were assessed for eligibility and 26 trials with 1733 critically ill patients were included. The median methodologic score was 9 out of 14 points (95% confidence interval [CI] 7, 10). Omega-6 FA sparing PN in comparison with traditional lipid emulsions did not decrease overall mortality (20 studies; risk ratio [RR] 0.91; 95% CI 0.76, 1.10; p = 0.34) but hospital length of stay was substantially reduced (6 studies; weighted mean difference [WMD] - 6.88; 95% CI - 11.27, - 2.49; p = 0.002). Among the different lipid emulsions, fish oil (FO) containing PN reduced the length of intensive care (8 studies; WMD - 3.53; 95% CI - 6.16, - 0.90; p = 0.009) and rate of infectious complications (4 studies; RR 0.65; 95% CI 0.44, 0.95; p = 0.03). When FO was administered as a stand-alone medication outside PN, potential mortality benefits were observed compared to standard care.Conclusion: Overall, these findings highlight distinctive omega-6 sparing effects attributed to PN. Among the different lipid emulsions, FO in combination with PN or as a stand-alone treatment may have the greatest clinical impact. Trial registration PROSPERO international prospective database of systematic reviews (CRD42021259238). [ABSTRACT FROM AUTHOR]

Published
2022
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198. Endoplasmic reticulum stress and the unfolded protein response in skeletal muscle of subjects suffering from peritoneal sepsis.

Author

Metzing, Uta Barbara, von Loeffelholz, Christian, Steidl, Ricardo, Romeike, Bernd, Winkler, René, Rauchfuß, Falk, Settmacher, Utz, Stoppe, Christian, Coldewey, Sina M., Weinmann, Claudia, Weickert, Martin O., Claus, Ralf A., Birkenfeld, Andreas L., Kosan, Christian, and Horn, Paul

Subjects
UNFOLDED protein response, SKELETAL muscle, ENDOPLASMIC reticulum, HEAT shock proteins, SEPSIS, LABORATORY mice
Abstract

We provide a descriptive characterization of the unfolded protein response (UPR) in skeletal muscle of human patients with peritoneal sepsis and a sepsis model of C57BL/6J mice. Patients undergoing open surgery were included in a cross-sectional study and blood and skeletal muscle samples were taken. Key markers of the UPR and cluster of differentiation 68 (CD68) as surrogate of inflammatory injury were evaluated by real-time PCR and histochemical staining. CD68 mRNA increased with sepsis in skeletal muscle of patients and animals (p < 0.05). Mainly the inositol-requiring enzyme 1α branch of the UPR was upregulated as shown by elevated X-box binding-protein 1 (XBP1u) and its spliced isoform (XBP1s) mRNA (p < 0.05, respectively). Increased expression of Gadd34 indicated activation of PRKR-Like Endoplasmic Reticulum Kinase (PERK) branch of the UPR, and was only observed in mice (p < 0.001) but not human study subjects. Selected cell death signals were upregulated in human and murine muscle, demonstrated by increased bcl-2 associated X protein mRNA and TUNEL staining (p < 0.05). In conclusion we provide a first characterization of the UPR in skeletal muscle in human sepsis. [ABSTRACT FROM AUTHOR]

Published
2022
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199. Additional file 5: of Genome-wide association study of myocardial infarction, atrial fibrillation, acute stroke, acute kidney injury and delirium after cardiac surgery â a sub-analysis of the RIPHeart-Study

Author

Westphal, Sabine, Stoppe, Christian, Gruenewald, Matthias, Bein, Berthold, Renner, Jochen, Cremer, Jochen, Coburn, Mark, Schaelte, Gereon, Boening, Andreas, Niemann, Bernd, Kletzin, Frank, Roesner, Jan, Strouhal, Ulrich, Reyher, Christian, Laufenberg-Feldmann, Rita, Ferner, Marion, Brandes, Ivo, Bauer, Martin, Kortgen, Andreas, Stehr, Sebastian, Wittmann, Maria, Baumgarten, Georg, Struck, Rafael, Meyer-Treschan, Tanja, Kienbaum, Peter, Heringlake, Matthias, Schoen, Julika, Sander, Michael, Treskatsch, Sascha, Smul, Thorsten, Wolwender, Ewa, Schilling, Thomas, Degenhardt, Frauke, Franke, Andre, Soeren Mucha, Tittmann, Lukas, Kohlhaas, Madeline, Fuernau, Georg, Brosteanu, Oana, Hasenclever, Dirk, Zacharowski, Kai, and Meybohm, Patrick

Abstract

Figure S2. Quantile-quantile plot showing the expected distribution of association test statistics across the SNPs compared to the observed values for AF, delirium, MI, renal failure and stroke. a) Adjustment for all other outcomes. b) No adjustment for all other outcomes and composite. (PDF 305 kb)

Published
2019
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200. Selenium-Binding Protein 1 Indicates Myocardial Stress and Risk for Adverse Outcome in Cardiac Surgery

Author

Kühn-Heid, Ellen C. D., Kühn, Eike C., Ney, Julia, Wendt, Sebastian, Seelig, Julian, Schwiebert, Christian, Minich, Waldemar B., Stoppe, Christian, and Schomburg, Lutz

Subjects
Male, Time Factors, lcsh:TX341-641, Selenium-Binding Proteins, selenoprotein, Risk Assessment, Article, redox regulation, Postoperative Complications, Predictive Value of Tests, Risk Factors, Humans, ddc:610, Aged, Cardiopulmonary Bypass, Myocardium, trace element, prediction, Middle Aged, Up-Regulation, Treatment Outcome, Heart Arrest, Induced, biomarker, Female, lcsh:Nutrition. Foods and food supply, metabolism, Biomarkers, 600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit
Abstract

Selenium-binding protein 1 (SELENBP1) is an intracellular protein that has been detected in the circulation in response to myocardial infarction. Hypoxia and cardiac surgery affect selenoprotein expression and selenium (Se) status. For this reason, we decided to analyze circulating SELENBP1 concentrations in patients (n = 75) necessitating cardioplegia and a cardiopulmonary bypass (CPB) during the course of the cardiac surgery. Serum samples were collected at seven time-points spanning the full surgical process. SELENBP1 was quantified by a highly sensitive newly developed immunological assay. Serum concentrations of SELENBP1 increased markedly during the intervention and showed a positive association with the duration of ischemia (&rho, = 0.6, p &lt, 0.0001). Elevated serum SELENBP1 concentrations at 1 h after arrival at the intensive care unit (post-surgery) were predictive to identify patients at risk of adverse outcome (death, bradycardia or cerebral ischemia, &ldquo, endpoint 1&rdquo, OR 29.9, CI 3.3&ndash, 268.8, p = 0.00027). Circulating SELENBP1 during intervention (2 min after reperfusion or 15 min after weaning from the CPB) correlated positively with an established marker of myocardial infarction (CK-MB) measured after the intervention (each with &rho, = 0.5, p &lt, 0.0001). We concluded that serum concentrations of SELENBP1 were strongly associated with cardiac arrest and the duration of myocardial ischemia already early during surgery, thereby constituting a novel and promising quantitative marker for myocardial hypoxia, with a high potential to improve diagnostics and prediction in combination with the established clinical parameters.

Published
2019
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