Kinetics of plasma biomarkers of inflammation and lung injury in surgical patients with or without postoperative pulmonary complications

A, Serpa Neto; Pp, Campos; Sn, Hemmes; Bos, Lieuwe D. J.; Bluth, Thomas; Ferner, Marion; Güldner, Andreas; Hollmann, Markus W.; India, Inmaculada; Kiss, Thomas; Laufenberg-Feldmann, R.; Šprung, Juraj; Sülemanji, Demet; Unzueta, Carmen; Mf, Melo; Tn, Weingarten; Am, Boer; Pelosi, Paolo; Abreu, Marcelo Gama de; Schultz, Marc J.

doi:10.1097/eja.0000000000000614

Cited by 34 publications

(23 citation statements)

References 29 publications

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“…This reinforces the hypothesis that volutrauma is more injurious than atelectrauma in non-obese rats. The absence of changes in mediators other than those associated with inflammation is consistent with post hoc analyses of the PROVHILO trial, in which high-PEEP leads to minimal changes in biological markers (Serpa Neto et al, 2017).…”

Section: Discussionsupporting

confidence: 79%

Effects of Protective Mechanical Ventilation With Different PEEP Levels on Alveolar Damage and Inflammation in a Model of Open Abdominal Surgery: A Randomized Study in Obese Versus Non-obese Rats

et al. 2019

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Section: Discussionsupporting

confidence: 79%

Effects of Protective Mechanical Ventilation With Different PEEP Levels on Alveolar Damage and Inflammation in a Model of Open Abdominal Surgery: A Randomized Study in Obese Versus Non-obese Rats

et al. 2019

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“…It plays a role in attenuation of inflammatory responses and, consequently, a higher serum CC16 level is associated with better outcomes in patients with acute respiratory distress syndrome [ 32 ]. Furthermore, a rapid increase of serum CC16 has been reported after lung distention injury, possibly to elicit protective effects [ 10 , 33 ]. In this study, serum CC16 levels were significantly increased between the baseline (T 1 ) and 1 hour after resumption of two lung (T 2 ) in both groups.…”

Section: Discussionmentioning

confidence: 99%

Effects of Dexmedetomidine Infusion on Inflammatory Responses and Injury of Lung Tidal Volume Changes during One-Lung Ventilation in Thoracoscopic Surgery: A Randomized Controlled Trial

Wang

et al. 2018

Mediators of Inflammation

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One-lung ventilation in thoracic surgery provokes profound systemic inflammatory responses and injury related to lung tidal volume changes. We hypothesized that the highly selective a2-adrenergic agonist dexmedetomidine attenuates these injurious responses. Sixty patients were randomly assigned to receive dexmedetomidine or saline during thoracoscopic surgery. There is a trend of less postoperative medical complication including that no patients in the dexmedetomidine group developed postoperative medical complications, whereas four patients in the saline group did (0% versus 13.3%, p = 0.1124). Plasma inflammatory and injurious biomarkers between the baseline and after resumption of two-lung ventilation were particularly notable. The plasma high-mobility group box 1 level decreased significantly from 51.7 (58.1) to 33.9 (45.0) ng.ml−1 (p < 0.05) in the dexmedetomidine group, which was not observed in the saline group. Plasma monocyte chemoattractant protein 1 [151.8 (115.1) to 235.2 (186.9) pg.ml−1, p < 0.05] and neutrophil elastase [350.8 (154.5) to 421.9 (106.1) ng.ml−1, p < 0.05] increased significantly only in the saline group. In addition, plasma interleukin-6 was higher in the saline group than in the dexmedetomidine group at postoperative day 1 [118.8 (68.8) versus 78.5 (58.8) pg.ml−1, p = 0.0271]. We conclude that dexmedetomidine attenuates one-lung ventilation-associated inflammatory and injurious responses by inhibiting alveolar neutrophil recruitment in thoracoscopic surgery.

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“…However, none of the ILs reached a sufficient prognostic value. [ 11 ] Patients with pulmonary complications after esophagectomy showed increased levels of IL-6 and IL-10. [ 12 ] IL-6 was used as a predictive biomarker of systemic inflammatory response after non-cardiac thoracic surgery without analyzing a possible impact on postoperative complications.…”

Section: Introductionmentioning

confidence: 99%

Perioperative cytokine profile during lung surgery predicts patients at risk for postoperative complications—A prospective, clinical study

et al. 2018

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BackgroundPostoperative complications after lung surgery are frequent, having a detrimental effect on patients’ further course. Complications may lead to an increased length of hospital stay and cause additional costs. Several risk factors have been identified but it is still difficult to predict contemporary which patients are at risk. We hypothesized that patients who show an increased inflammatory response at the time of wound closure and 24 hours after surgery are at risk of postoperative complications within 30 days after surgery.MethodsPostoperative complications (pulmonary, cardiac, neurological and renal) of 96 patients scheduled for lung surgery at the Medical Center–University of Freiburg were analyzed in this prospective, clinical study. Blood samples for cytokine analysis (Interleukin (IL)-6, IL-8, IL-10, Tumor necrosis factor [TNF]-α, IL-1ß and IL12p70) were taken before surgery, at wound closure and 24 hours after surgery. Cytokine levels of patients with and without postoperative complications were analyzed by Receiver operating characteristic (ROC) curve analysis. To adjust the results according to existing covariates a multivariate logistic regression analysis was conducted.ResultsThe complication and non-complication group differed significantly according to nicotine dependency, Angiotensin-receptor-II blocker medication, rate of thoracotomy and preoperative lung function. The intraoperative hemodynamic parameters and therapy did not differ between the groups. Twenty-nine patients (30%) developed postoperative complications within 30 days after surgery. Plasma concentrations of IL-6, IL-10 and IL-8 at the time of wound closure and 24 hours after surgery were higher in the complication group. Multivariate regression analysis on postoperative complications revealed an Odds ratio of 56 for patients with IL-6 and IL-8 levels above the 3rd quartile measured on the first postoperative day.ConclusionsPerioperative detection of increased plasma concentrations of inflammatory cytokines in lung surgery may be used in addition to other clinical predictors to identify patients at risk for postoperative complications.Trial registrationGerman Clinical Trials Register 00006961.

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Kinetics of plasma biomarkers of inflammation and lung injury in surgical patients with or without postoperative pulmonary complications

Abstract: The PROVHILO trial, including this substudy, was registered at clinicaltrials.gov (NCT01441791).

Cited by 34 publications

References 29 publications

Effects of Protective Mechanical Ventilation With Different PEEP Levels on Alveolar Damage and Inflammation in a Model of Open Abdominal Surgery: A Randomized Study in Obese Versus Non-obese Rats

Effects of Protective Mechanical Ventilation With Different PEEP Levels on Alveolar Damage and Inflammation in a Model of Open Abdominal Surgery: A Randomized Study in Obese Versus Non-obese Rats

Effects of Dexmedetomidine Infusion on Inflammatory Responses and Injury of Lung Tidal Volume Changes during One-Lung Ventilation in Thoracoscopic Surgery: A Randomized Controlled Trial

Perioperative cytokine profile during lung surgery predicts patients at risk for postoperative complications—A prospective, clinical study

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