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Procalcitonin in patients undergoing cardiopulmonary bypass in open heart surgery-first results of the Procalcitonin in Heart Surgery study (ProHearts).
- Source :
-
Intensive care medicine [Intensive Care Med] 2000 Mar; Vol. 26 Suppl 2, pp. S193-8. - Publication Year :
- 2000
-
Abstract
- Objective: To investigate procalcitonin (PCT) levels in patients undergoing cardiopulmonary bypass (CPB) in order to assess the prevalence and prognostic capacity of elevated PCT levels following CPB in open heart surgery.<br />Design: prospective observational study in consecutive patients.<br />Setting: Twenty-four-bed ICU, department of thoracic and cardiovascular surgery, university hospital.<br />Patients: Seven hundred and twenty two patients, 691 of whom underwent CPB, i.e., 476 had coronary bypass surgery (CABG), 130 valve replacement, 34 combined CABG and valve replacement and 23 thoracic aortic surgery.<br />Interventions: Standard perfusion techniques were used with cardioplegic arrest and mild hypothermia (28-32 degrees C). With the exception of thoracic aortic procedures, full-flow perfusion was performed.<br />Measurements and Results: PCT was measured prior to surgery and daily thereafter until ICU discharge or death. PCT significantly increased at day 1 postoperatively compared to baseline values (0.25+/-1.65 vs 6.49+/-22.0 ng/ml, p<0.005). However, in 55.1% of patients PCT was below 1.0 ng/ml. In 12.8% of CABG patients PCT was increased to >5.0 ng/ml, compared to 39% in valve patients and 35% of patients with aortic surgery. An elevated PCT level >1.0-5.0 ng/ml at day 1 was highly predictive of mortality (P<0.03, vs<1.0 ng/ml), with an additional accuracy when levels >5.0 ng/ml were measured (P<0.002 vs<1.0 ng/ml).<br />Conclusions: These results provide evidence that PCT might serve as an early prognostic marker in patients undergoing CPB in open heart surgery. It may be worth considering immunomodulating approaches in patients presenting elevated PCT levels in the early phase after CPB.
- Subjects :
- Adult
Aged
Aged, 80 and over
Analysis of Variance
Biomarkers blood
C-Reactive Protein analysis
Calcitonin Gene-Related Peptide
Cardiac Surgical Procedures statistics & numerical data
Cardiopulmonary Bypass statistics & numerical data
Female
Heart Diseases surgery
Humans
Male
Middle Aged
Postoperative Complications epidemiology
Prospective Studies
Sensitivity and Specificity
Calcitonin blood
Cardiac Surgical Procedures adverse effects
Cardiopulmonary Bypass adverse effects
Postoperative Complications blood
Postoperative Complications diagnosis
Protein Precursors blood
Subjects
Details
- Language :
- English
- ISSN :
- 1432-1238
- Volume :
- 26 Suppl 2
- Database :
- MEDLINE
- Journal :
- Intensive care medicine
- Publication Type :
- Academic Journal
- Accession number :
- 18470719
- Full Text :
- https://doi.org/10.1007/BF02900737