Early blood biomarkers predict organ injury and resource utilization following complex cardiac surgery

Abstract

Background-Patients undergoing complex cardiac surgery (thoracic aorta and valve) are at risk for organ failure and increased resource utilization. Neutrophil gelatinase-associated lipocalin (NGAL) has been found to be an early biomarker for renal injury. Multiplex cytokine immunoassays allow the evaluation of the early inflammatory response. We examined the relationship between early biomarker appearance (NGAL and multiplex cytokines) and organ injury and resource utilization.

Continuous Monitoring of Inflammation Biomarkers During Simulated Cardiopulmonary Bypass Using a Microfluidic Immunoassay Device—A Pilot Study

“…The purpose of this work is to develop an automated assay that can continuously monitor systemic inflammation during and following cardiac surgical procedures, especially those involving cardiopulmonary bypass (CPB). Numerous studies have investigated the complex systemic inflammatory responses and comorbidity resulting from cardiac surgery, particularly when CPB is used (1,2). This "systemic inflammatory response syndrome" is characterized by complement, neutrophil, and platelet activation, and release of proinflammatory cytokines.…”

“…These systemic inflammatory responses are attributed to numerous surgical and clinical factors, including the exposure of blood to the nonphysiologic surfaces of the heart-lung circuit, ischemia/reperfusion injury of the involved tissues as blood flow is stopped (resulting in tissue ischemia) and restarted (resulting in reperfusion injury), surgical trauma and vacuum-assisted venous drainage, and hypothermia (3). The systemic inflammatory syndrome is the primary cause of many postoperative complications resulting in vital organ dysfunction, multiorgan failure, and even death (1)(2)(3). Furthermore, the intensity of the inflammatory response is directly correlated with the severity of CPB-related morbidity (4).…”