Reference : Pancreatic cellular injury after cardiac surgery with cardiopulmonary bypass: Frequency,...
Scientific journals : Article
Human health sciences : Anesthesia & intensive care
Human health sciences : Hematology
http://hdl.handle.net/2268/7174
Pancreatic cellular injury after cardiac surgery with cardiopulmonary bypass: Frequency, time course and risk factors
English
Nys, Monique mailto [Centre Hospitalier Universitaire de Liège - CHU > > Soins intensifs >]
Venneman, Ingrid [Centre Hospitalier Universitaire de Liège - CHU > > Anesthésie et réanimation >]
Deby-Dupont, G. [> > > >]
Preiser, Jean-Charles [Université de Liège - ULg > Services généraux (Faculté de médecine) > Relations académiques et scientifiques (Médecine) >]
Vanbelle, Sophie mailto [Université de Liège - ULg > Département des sciences de la santé publique > Informatique médicale et biostatistique >]
Albert, Adelin mailto [Université de Liège - ULg > Département des sciences de la santé publique > Informatique médicale et biostatistique >]
Camus, Gérard [> > > >]
Damas, Pierre mailto [Université de Liège - ULg > Département des sciences cliniques > Anesthésie et réanimation]
Larbuisson, Robert mailto [Centre Hospitalier Universitaire de Liège - CHU > > Anesthésie et réanimation >]
Lamy, Maurice mailto [Université de Liège - ULg > Département des sciences cliniques > Anesthésie et réanimation]
May-2007
Shock (Augusta, Ga.)
Lippincott Williams & Wilkins
27
5
474-481
Yes (verified by ORBi)
International
1073-2322
Philadelphia
PA
[en] pancreas ; cardiac surgery ; bypass ; myeloperoxidase ; trypsin ; amylase
[en] Although often clinically silent, pancreatic cellular injury (PCI) is relatively frequent after cardiac surgery with cardiopulmonary bypass; and its etiology and time course are largely unknown. We defined PCI as the simultaneous presence of abnormal values of pancreatic isoamylase and immunoreactive trypsin (IRT). The frequency and time evolution of PCI were assessed in this condition using assays for specific exocrine pancreatic enzymes. Correlations with inflammatory markers were searched for preoperative risk factors. One hundred ninety-three patients submitted to cardiac surgery were enrolled prospectively. Blood IRT, amylase, pancreatic isoamylase, lipase, and markers of inflammation (alpha1-protease inhibitor, alpha2-macroglobulin, myeloperoxidase) were measured preoperatively and postoperatively until day 8. The postoperative increase in plasma levels of pancreatic enzymes and urinary IRT was biphasic in all patients: early after surgery and later (from day 4 to 8 after surgery). One hundred thirty-three patients (69%) experienced PCI, with mean IRT, isoamylase, and alpha1-protease inhibitor values higher for each sample than that in patients without PCI. By multiple regression analysis, we found preoperative values of plasma IRT >or=40 ng/mL, amylase >or=42 IU/mL, and pancreatic isoamylase >or=20 IU/L associated with a higher incidence of postsurgery PCI (P < 0.005). In the PCI patients, a significant correlation was found between the 4 pancreatic enzymes and urinary IRT, total calcium, myeloperoxidase, alpha1-protease inhibitor, and alpha2-macroglobulin. These data support a high prevalence of postoperative PCI after cardiac surgery with cardiopulmonary bypass, typically biphasic and clinically silent, especially when pancreatic enzymes were elevated preoperatively.
http://hdl.handle.net/2268/7174
10.1097/shk.0b013e31802b65f8

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