Effect of sepsis and cardiac surgery with cardiopulmonary bypass on plasma level of nitric oxide metabolites, neopterin, and procalcitonin: correlation with mortality and postoperative complications

Abstract

Our results confirm the value of PCT and neopterin measurement as diagnostic tools in monitoring the clinical course of patients in intensive care units.

Serum Procalcitonin as a Valuable Diagnostic Tool in the Early Detection of Infectious Complications after Open Abdominal Aortic Repair

“…OAR is a major abdominal operation, but unlike general surgery, it represents a -clean‖ intervention, as respiratory, alimentary, and genitourinary tracts are not involved, thus infections are expected to be lower in this field. According to most of the aforementioned studies, 10,11,15,[19][20][21] we focused our attention on the evaluation of only infectious complications. In our series, 29% of patients developed infectious complications.…”

“…During the first and second postoperative day (POD), PCT concentrations are more frequently elevated in patients after major surgery compared with patients undergoing minor operations. [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] Previous studies assessed PCT and its relationship with adverse postoperative events, mainly with regard to cardiac surgery, 8.22 whereas very little evidence exists so far regarding infectious complications after aortic surgery. [23][24][25][26] One of the most relevant aspects of PCT is its good specificity (SP), which has been recently demonstrated in the detection of postimplantation syndrome after endovascular repair.…”

Procalcitonin and Interleukin-6 Levels: Are They Useful Biomarkers in Cardiac Surgery Patients?

“…Our data are supported by previous studies, which have demonstrated that PCT levels are correlated with several severity-of-illness scoring systems used in clinical practice, such as Acute Physiology and Chronic Health Evaluation, Simplified Acute Physiology Score II and Sequential Organ Failure Assessment scores [38] . Postoperative PCT levels have also been reported to be higher in cardiac surgery patients developing postoperative myocardial infarction [39] , renal and hepatic dysfunction in addition to respiratory and circulatory insufficiency [40] . In our study, PCT showed a good predictive value for both AKI and worsening of CKD.…”

Neopterin as a Biomarker in Patients with Pulmonary Arterial Hypertension and Chronic Thromboembolic Pulmonary Hypertension

“…In addition, the risk of clinical deterioration in the subgroup with a NP concentration ≥15.3 nmol/L was more than 4-fold higher than in the subgroup with a lower concentration of NP. In previous studies, a cutoff value of 14.5 nmol/L in surgical patients predicted postoperative complications after operations with cardiopulmonary bypass [35], while in patients after an acute coronary syndrome event, an NP level ≥12.11 nmol/L was associated with an increased risk of death and/or acute coronary events after adjustment for clinical variables [16]. Nevertheless, we measured serum NP concentration which reflects an upregulated inflammatory response in the whole circulatory system; therefore, we can only hypothesize that production of NP locally in lung tissue, where specific inflammatory infiltrates in the perivascular space are found, is significantly elevated as well.…”