1. Protein Profiling in Serum and Cerebrospinal Fluid Following Complex Surgery on the Thoracic Aorta Identifies Biological Markers of Neurologic Injury.
- Author
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Lindblom RPF, Shen Q, Axén S, Landegren U, Kamali-Moghaddam M, and Thelin S
- Subjects
- Aged, Biomarkers blood, Biomarkers cerebrospinal fluid, Delirium blood, Delirium cerebrospinal fluid, Delirium diagnosis, Female, Hallucinations blood, Hallucinations cerebrospinal fluid, Hallucinations diagnosis, Humans, Male, Middle Aged, Predictive Value of Tests, Risk Factors, Spinal Cord Injuries blood, Spinal Cord Injuries cerebrospinal fluid, Spinal Cord Injuries diagnosis, Trauma, Nervous System blood, Trauma, Nervous System cerebrospinal fluid, Trauma, Nervous System etiology, Treatment Outcome, Aorta, Thoracic surgery, Aortic Diseases surgery, Blood Proteins metabolism, Cerebrospinal Fluid Proteins cerebrospinal fluid, Proteomics methods, Trauma, Nervous System diagnosis, Vascular Surgical Procedures adverse effects
- Abstract
Surgery on the arch or descending aorta is associated with significant risk of neurological complications. As a consequence of intubation and sedation, early neurologic injury may remain unnoticed. Biomarkers to aid in the initial diagnostics could prove of great value as immediate intervention is critical. Twenty-three patients operated in the thoracic aorta with significant risk of perioperative neurological injury were included. Cerebrospinal fluid (CSF) and serum were obtained preoperatively and in the first and second postoperative days and assessed with a panel of 92 neurological-related proteins. Three patients suffered spinal cord injury (SCI), eight delirium, and nine hallucinations. There were markers in both serum and CSF that differed between the affected and non-affected patients (SCI; IL6, GFAP, CSPG4, delirium; TR4, EZH2, hallucinations; NF1). The study identifies markers in serum and CSF that reflect the occurrence of neurologic insults following aortic surgery, which may aid in the care of these patients.
- Published
- 2018
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