Introduction: Acute kidney injury (AKI) is a sudden decrease in kidney function due to damage within seven days or less, thus inducing an early stress response that can be promptly detected by biomarkers, such as Neutrophil Gelatinase-Associated Lipocalin (NGAL). The aim of this study was to analyse the role of NGAL level as a biomarker of postoperative prerenal AKI in patients who underwent otorhinolaryngology surgery with controlled hypotension. Methods: A prospective study was conducted among patients that underwent otorhinolaryngology surgery with controlled hypotension. Patients were selected with purposive sampling. NGAL level was measured using enzyme-linked immunosorbent assay (ELISA) from venous blood collected 1-hour pre- and 2-hour post-surgery. NGAL levels were compared between preoperative and postoperative states. Wilcoxon and Spearman test were used to determine the correlation between NGAL levels and parameters of AKI. Results: A total of 30 patients underwent a varies of otorhinolaryngology surgeries were recruited in this study. Our data suggested no significant different between the level of NGAL during preoperative and postoperative (184.73±120.09 ng/mL vs 175.80±129.97 ng/mL). Pre-operative laboratory parameters of AKI such as blood urea nitrogen (BUN), serum creatine (SCr), BUN/SCr ratio, and GFR had no correlation with postoperative NGAL level. In addition, systolic blood pressure, diastolic blood pressure, MAP, heart rate, EtCO2, duration of surgery and the duration of controlled hypotension had no correlation with postoperative NGAL. Conclusion: NGAL levels have nonsignificant role as biomarker of incidence of postoperative prerenal AKI in patients who receiving otorhinolaryngology surgery with controlled hypotension. However, further study with the bigger sample size is warrant to confirm the findings of this study.

Introduction: Controlled hypotension is one of the techniques applied to several microscopic ear, nose, and throat (ENT) surgeries. However, this technique has risks and complications, which result in impaired perfusion and oxygenation of organs including the brain that could trigger the postoperative cognitive dysfunction (POCD). Damage that occurs in brain cells can trigger the secretion of biomarker proteins in the blood, one of which is S100B which can indicate nerve damage in the intra and postoperative period. This study aimed to analyze the correlation between S100B protein level and the incidence of POCD in patients who received ENT surgeries with controlled hypotension. Methods: A cross-sectional study was conducted among patients that underwent elective ENT surgeries at Dr. Soetomo General Academic Hospital, Surabaya, from July to August 2022. Cognitive function was assessed using Mini-mental State Examination (MMSE) at 12 hours before and 2 and 24 hours after surgery. The level of S100B was measured using enzyme-linked immunosorbent assay (ELISA) 12 hours prior surgery and 30 minutes post-surgery. Results: A total of 31 patients were recruited in the study, including a mean age of 31.7 years. The mean S100B levels in POCD patients pre- and postoperative were 311.97 ng/L, and 415.34 ng/L, respectively. In non-POCD patients, the mean levels of S100B pre and postoperative were 436.90 ng/L, and 444.29 ng/L, respectively. There were 3 (9.7%) patients experienced POCD. Our data suggested there was a significant difference between preoperative and postoperative S100B levels in the groups of patients with POCD (103.37ng/L) and non-POCD (7.38 ng/L) (p<0.001). Patients that experienced POCD had significantly increased S100B compared to those who did not. Conclusion: There is a correlation between changes of S100B levels and the incidence of POCD in patients undergoing ENT surgeries with controlled hypotension.