‘Lone’ increase in C-reactive protein after cardiac surgery: prevalence, clinical characteristics, in-hospital course, and prognostic value

Piccoli, Mara; Cerquetani, Elena; Pastena, Guglielmo; Posteraro, Alfredo; Amici, Elisabetta; Romeo, Maria Daniela; Carrubba, Salvatore La; Salustri, Alessandro

doi:10.1097/hjr.0b013e328301a5eb

Cited by 6 publications

(3 citation statements)

References 32 publications

(51 reference statements)

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“…This observation is supported by the literature, which states that CRP is involved in the acute phase reaction after surgery. 21 The median CRP value was significantly higher in patients with infection on the third postoperative day. A CRP peak above the 75th percentile on the third day has been shown to be associated with infection.…”

Section: Discussionmentioning

confidence: 87%

Procalcitonin and white blood cells, combined predictors of infection in cardiac surgery patients

Heredia-Rodríguez

Bustamante‐Munguira

Lorenzo

et al. 2017

Journal of Surgical Research

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Section: Discussionmentioning

confidence: 87%

Procalcitonin and white blood cells, combined predictors of infection in cardiac surgery patients

Heredia-Rodríguez

Bustamante‐Munguira

Lorenzo

et al. 2017

Journal of Surgical Research

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“…Our findings may be substantiated by those from Sophie et al and Mara et al, who found that post-operative CRP levels at the time of patients discharge from ICU did not necessarily indicate any clinical post-ICU adverse outcomes. 20 – 21 …”

Section: Discussionmentioning

confidence: 99%

Acute systemic inflammatory response after cardiac surgery in patients infected with human immunodeficiency virus using clinical and inflammatory markers

Gojo¹,

Prakaschandra

2017

Afr H. Sci.

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BackgroundImmediate post-cardiopulmonary bypass (CPB) immune responses and organ injuries in immune-compromised patients remain poorly documented.MethodSixty-one consecutive patients (30 HIV seropositive and 31 seronegative), undergoing elective cardiac valve(s) replacement were enrolled, from a single center hospital, after informed consent was obtained. C-reactive protein (CRP) and Erythrocyte sedimentation rate (ESR) were used as biomarkers of acute inflammatory response.ResultsThe mean age was similar between the HIV seropositive and negative group. Pre-operatively, CRP (p=0.388) and ESR (p=0.817) were comparable. The CPB events and durations were significantly different between the two groups: duration (p=0.021), clamp aortic duration (p=0.026), bloodtransfusion (p=0.013), total urine output (p=0.035) and peak lactate (p=0.040). Post-operatively, there was significant increased biomarkers level in both groups, albeit not between the groups with a significant negative correlation between the mean change in CRP levels and mechanical ventilation (r=0.548, p=0.002) in the seropositive group (r=0.025, p=0.893). The correlation between pre-operative and post-operative difference in CRP and ICU stay was not significant in both groups. A significant drop (p=<0.001) in CD4 cells was documented post-operatively in the HIV seropositive group.ConclusionHIV positive patients' post-operative reactions to cardiac surgery supported by CPB are similar to those of HIV seronegative patients.

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“…These stimuli can also affect genetic mechanisms controlling immune system activation [7][8][9][10]. Consequently, surgery-triggered effects may persist well past the initial insult [5,[11][12][13][14][15][16][17]. While sepsis trials demonstrate that early immune reprogramming determines its short-and long-term performance, similar data for cardiac surgery are lacking [17][18][19][20][21][22].…”

Section: Introductionmentioning

confidence: 99%

Whole Blood Reactivity to Viral and Bacterial Pathogens after Non-Emergent Cardiac Surgery during the Acute and Convalescence Periods Demonstrates a Distinctive Profile of Cytokines Production Compared to the Preoperative Baseline in Cohort of 108 Patients, Suggesting Immunological Reprogramming during the 28 Days Traditionally Recognized as the Post-Surgical Recovery Period

Laudanski,

Liu,

Karnatovskaia

et al. 2023

Biomedicines

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The release of danger signals from tissues in response to trauma during cardiac surgery creates conditions to reprogram the immune system to subsequent challenges posed by pathogens in the postoperative period. To demonstrate this, we tested immunoreactivity before surgery as the baseline (tbaseline), followed by subsequent challenges during the acute phase (t24h), convalescence (t7d), and long-term recovery (t3m). For 108 patients undergoing elective heart surgery, whole blood was stimulated with lipopolysaccharide (LPS), Influenza A virus subtype N2 (H3N2), or the Flublok™ vaccine to represent common pathogenic challenges. Leukocytosis, platelet count, and serum C-reactive protein (CRP) were used to measure non-specific inflammation. Cytokines were measured after 18 h of stimulation to reflect activation of the various cell types (activated neutrophils–IL-8; activated T cells-IL-2, IFNγ, activated monocyte (MO)-TNFα, IL-6, and deactivated or atypically activated MO and/or T cells–M-CSF, IL-10). IL-2 and IL-10 were increased at t7d, while TNFα was suppressed at t24h when LPS was utilized. Interestingly, M-CSF and IL-6 production was elevated at seven days in response to all stimuli compared to baseline. While some non-specific markers of inflammation (white cell count, IL-6, and IL-8) returned to presurgical levels at t3m, CRP and platelet counts remained elevated. We showed that surgical stimulus reprograms leukocyte response to LPS with only partial restoration of non-specific markers of inflammation.

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‘Lone’ increase in C-reactive protein after cardiac surgery: prevalence, clinical characteristics, in-hospital course, and prognostic value

Cited by 6 publications

References 32 publications

Procalcitonin and white blood cells, combined predictors of infection in cardiac surgery patients

Procalcitonin and white blood cells, combined predictors of infection in cardiac surgery patients

Acute systemic inflammatory response after cardiac surgery in patients infected with human immunodeficiency virus using clinical and inflammatory markers

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