Comparison of the acute-phase response after laparoscopic versus open aortobifemoral bypass surgery: a substudy of a randomized controlled trial

Krog, Anne Helene; Sahba, Mehdi; Pettersen, Erik Mulder; Sandven, Irene; Thorsby, Per Medbøe; Jørgensen, Jørgen J.; Sundhagen, Jon Otto; Kazmi, Syed Sajid Hussain

doi:10.2147/vhrm.s110600

Cited by 13 publications

(13 citation statements)

References 39 publications

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“…However, the value of following trends in [SAA] and [fibrinogen] after exploratory celiotomy has only been reported in small numbers of horses (18 horses [7], 51 horses [8]). In man, [SAA] can be used to compare post-operative outcomes between different surgical procedures [9,10]. Similar findings are reported in horses, where increases in [SAA] occur as early as 12 h after elective surgical procedures [3].…”

Section: Introductionmentioning

confidence: 63%

Serum amyloid A and plasma fibrinogen concentrations in horses following emergency exploratory celiotomy

Cozar

Sherlock

Knowles

et al. 2019

Equine Veterinary Journal

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Summary Background Acute‐phase proteins may help assess the nature and severity of lesions and outcome in horses undergoing colic surgery. Objectives To compare serum amyloid A and plasma fibrinogen concentrations ([SAA] and [fibrinogen]) in the immediate post‐operative period after exploratory celiotomy and determine their value in assessment of post‐operative complications and survival to discharge. Study design Observational study. Methods This study included horses over 1 year of age undergoing exploratory celiotomy. Surgical procedures, lesions, post‐operative care, complications and survival to discharge were recorded. [SAA] and [fibrinogen] were measured prior to surgery and 5 days post‐operatively. Statistical analyses included Yate's Chi‐square test, linear mixed effects model, Mann–Whitney U test and logistic regression. Results Of 300 horses, 52.0% developed post‐operative complications and 83.7% survived to discharge, with significantly reduced chance of survival in horses that developed post‐operative complications (P<0.01). Median [SAA] at days 1, 2, 3, 4 and 5 and median [fibrinogen] at days 3, 4 and 5 were significantly different between horses that did and did not develop post‐operative complications (P<0.05). Median [SAA] at days 1, 4 and 5 were significantly different between horses that did and did not survive to discharge (P<0.05). Logistic regression revealed post‐operative complications to be associated with strangulating lesions (OR 2.35, 95% confidence interval [CI] 1.41–3.91, P≤0.001) and higher [fibrinogen] at admission (OR 1.21, 95% CI 1.00–1.45, P<0.05), and survival to discharge to be associated with lower [SAA] at 5 days post‐operatively (OR 0.965, 95% CI 0.94–0.99, P = 0.002). Main limitations A large variety of lesions and complications prevented detailed analysis of associations between inflammatory markers, lesions and complications. Conclusions Horses that develop post‐operative complications have acute‐phase responses of greater magnitudes and durations compared with those that do not develop complications. This is also seen in horses that do not survive to discharge. Measuring [SAA] daily and [fibrinogen] at admission, may help predict the development of post‐operative complications.

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Section: Introductionmentioning

confidence: 63%

Serum amyloid A and plasma fibrinogen concentrations in horses following emergency exploratory celiotomy

Cozar

Sherlock

Knowles

et al. 2019

Equine Veterinary Journal

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“…Studies have profiled changes in cytokine of wild-type patients after laparoscopy, but this has not been well studied in patients with SCA (hemoglobin SS [HbSS]). 9–11 Laparoscopy may provide additional benefit over open cholecystectomy in patients with SCA by reducing systemic inflammation and mitigating against the enhanced surgical stress response.…”

Section: Introductionmentioning

confidence: 99%

The Inflammatory Response to Surgery in Sickle Cell Disease Patients Undergoing Cholecystectomy

Adisa

Adedeji

Bolarinwa

et al. 2019

JSLS

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Background and Objectives: Patients with sickle cell anemia (SCA) may have elevated inflammatory markers in health, and this may be heightened after open operations. The inflammatory response of patients with SCA after minimally invasive surgeries has not been fully explored. Patients and Methods: Consecutive patients with SCA and with hemoglobin AA (HbAA) undergoing laparoscopic cholecystectomy for acute cholecystitis were recruited into the study. Blood samples were taken before induction of anesthesia (0-h); at 4, 12, 24, and 48 h; and on postoperative day 7. Samples were analyzed for serum C-reactive protein and interleukin (IL)-1 through IL-18. Results: Twenty-three patients, including 9 with SCA and 14 with HbAA, were recruited with 4 cases performed by open laparotomy. At 0-h, proinflammatory IL-1 levels (6.1 versus 4.8) and C-reactive protein levels (32.5 versus 26.6) were higher in patients with hemoglobin SS (HbSS) than in patients with HbAA, respectively. Over time, inflammatory markers were generally higher at each time-point for patients with HbSS compared with patients with HbAA for both proinflammatory and anti-inflammatory cytokines, rising immediately after surgery and up to 48 hours, then returning to baseline by postoperative day 7. There was a higher mean IL-1 level across all time-points in the HbSS group than in the HbAA group ( P = .04). Conclusion: This exploratory study found an enhanced inflammatory response to cholecystectomy in patients with SCA compared with patients with HbAA. Minimally invasive surgical strategies for this patient group may help to mediate this response.

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“…The laboratory values (CRP, TLC, and NLR) that we utilized are accepted as simple, cheap and easily available markers and used to reflect inflammation response by various studies (18,19). Both CRP and NLR are utilized in various malignancies as a prognostic marker as well (14).…”

Section: Discussionmentioning

confidence: 99%

“…We calculated the delta value of these variables as mentioned in the material method section to overcome this issue. It was claimed that serum CRP levels reflect the APR earlier than the other nonspecific biomarkers like NLR (19) and in our study, we collected the laboratory values before PDT and one day later. This might explain why the difference between groups was statistically significant with respect to CRP and TLC while it was not significant according to NLR.…”

Section: Discussionmentioning

confidence: 99%

The Comparative Changes in Inflammatory Markers Between Fiber Optic Bronchoscopy Guided and Classical Percutaneous Dilatational Tracheostomy

Mungan¹,

Sarı²,

Dicle³

et al. 2020

Crit Intensive Care

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Aim: Approximately ¼ of mechanically ventilated patients undergo tracheostomy in the intensive care units and percutaneous dilatational tracheostomy (PDT) replaces traditional open surgical tracheostomy. Various studies compare tracheostomy techniques according to safety, efficacy and cost affectivity. The biomarkers are used to reflect systemic acute-phase reaction (APR) which is in accordance with the severity of the tissue trauma. In the present study, we aimed to describe APR in patients undergoing PDT with or without bronchoscopy guidance, by analyzing changes in chosen inflammatory biomarkers. Study design: This single-center, retrospective descriptive study of 231 patients who underwent PDT was conducted between July 2016 and December 2018, in our tertiary ICU. Materials and Methods: The demographic data, the clinical outcomes and inflammatory biomarkers before and after PDT were derived from the hospital's database. All statistical analyses were performed with SPSS version 24 and for all analyses, a p-value ≤ 0.05 was regarded as statistically significant. Results: In this study, we compared the acute phase reaction caused by Fiber Optic Bronchoscopy Guided PDT and Classical PDT using inflammatory markers. Although the length of hospital and intensive care unit stay was longer with the guidance of bronchoscopy, the difference was not statistically significant between groups. In terms of inflammatory markers, the difference between the groups was found statistically significant. Conclusion: PDT was compared to open surgical tracheostomy (OST) largely in the literature and it was found less inflammation-related while we found that FOB guidance related less inflammatory response and the relative changes in APR were less.

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Comparison of the acute-phase response after laparoscopic versus open aortobifemoral bypass surgery: a substudy of a randomized controlled trial

Cited by 13 publications

References 39 publications

Serum amyloid A and plasma fibrinogen concentrations in horses following emergency exploratory celiotomy

Serum amyloid A and plasma fibrinogen concentrations in horses following emergency exploratory celiotomy

The Inflammatory Response to Surgery in Sickle Cell Disease Patients Undergoing Cholecystectomy

The Comparative Changes in Inflammatory Markers Between Fiber Optic Bronchoscopy Guided and Classical Percutaneous Dilatational Tracheostomy

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