Soluble isoform of the receptor for advanced glycation end products as a biomarker for postoperative respiratory failure after cardiac surgery.
Soluble isoform of the receptor for advanced glycation end products as a biomarker for postoperative respiratory failure after cardiac surgery.
复制标题
DOI：
10.1371/journal.pone.0070200
复制
发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Makita K
中科院分区：
文献类型：
--
作者：
Uchida T;Ohno N;Asahara M;Yamada Y;Yamaguchi O;Tomita M;Makita K
术后呼吸衰竭是一个主要问题，会延长心脏手术患者在重症监护室的停留时间。我们测量了晚期糖基化终末产物受体可溶性亚型 (sRAGE) 的血清水平，并研究了其与术后呼吸衰竭的关系。这项在三所大学医院进行的多中心观察研究招募了 87 名接受择期心脏手术的患者。围手术期测量血清生物标志物水平，并收集术后7天的临床数据。研究机械通气的持续时间为 28 天。与麻醉诱导后的水平（中位数，884 pg/mL；IQR，568-1462 pg/mL）相比，手术后 sRAGE 血清水平立即升高（中位数，1751 pg/mL；四分位距（IQR）1080-3034 pg/mL）。接受非体外循环冠状动脉旁路移植术的患者术后 sRAGE 水平（中位数，1193 pg/mL；IQR 737-1869 pg/mL）显着低于接受主动脉手术（中位数，1883 pg/mL；IQR，1406-4456 pg/mL；p = 0.0024）和瓣膜手术的患者（中位数，2302 pg/mL；IQR，1447–3585 pg/mL；p = 0.0005），术后 sRAGE 与体外循环持续时间中度相关（rs = 0.44，p<0.0001）。受试者工作特征曲线分析表明，术后 sRAGE 对术后呼吸衰竭（定义为机械通气时间延长 >3 天）具有预测性能，曲线下面积为 0.81（95% 置信区间 0.71-0.88）。预测呼吸衰竭的最佳截断值为 3656 pg/mL，敏感性和特异性分别为 62% 和 91%。心脏手术后血清sRAGE水平立即升高，升高范围与术后呼吸衰竭的发生率相关。术后早期 sRAGE 水平似乎与体外循环有关，并且可能对术后呼吸衰竭具有预测作用；然而，需要进行大规模的验证研究。
Postoperative respiratory failure is a major problem which can prolong the stay in the intensive care unit in patients undergoing cardiac surgery. We measured the serum levels of the soluble isoform of the receptor for advanced glycation end products (sRAGE), and we studied its association with postoperative respiratory failure. Eighty-seven patients undergoing elective cardiac surgery were enrolled in this multicenter observational study in three university hospitals. Serum biomarker levels were measured perioperatively, and clinical data were collected for 7 days postoperatively. The duration of mechanical ventilation was studied for 28 days. Serum levels of sRAGE elevated immediately after surgery (median, 1751 pg/mL; interquartile range (IQR) 1080–3034 pg/mL) compared with the level after anesthetic induction (median, 884 pg/mL; IQR, 568–1462 pg/mL). Postoperative sRAGE levels in patients undergoing off-pump coronary artery bypass grafting (median, 1193 pg/mL; IQR 737–1869 pg/mL) were significantly lower than in patients undergoing aortic surgery (median, 1883 pg/mL; IQR, 1406–4456 pg/mL; p = 0.0024) and valve surgery (median, 2302 pg/mL; IQR, 1447–3585 pg/mL; p = 0.0005), and postoperative sRAGE correlated moderately with duration of cardiopulmonary bypass (rs = 0.44, p<0.0001). Receiver operating characteristic curve analysis demonstrated that postoperative sRAGE had a predictive performance with area under the curve of 0.81 (95% confidence interval 0.71–0.88) for postoperative respiratory failure, defined as prolonged mechanical ventilation >3 days. The optimum cutoff value for prediction of respiratory failure was 3656 pg/mL, with sensitivity and specificity of 62% and 91%, respectively. Serum sRAGE levels elevated immediately after cardiac surgery, and the range of elevation was associated with the morbidity of postoperative respiratory failure. Early postoperative sRAGE levels appear to be linked to cardiopulmonary bypass, and may have predictive performance for postoperative respiratory failure; however, large-scale validation studies are needed.
登录
查看更多内容
影响因子：
9.6
作者：
Briot R;Frank JA;Uchida T;Lee JW;Calfee CS;Matthay MA
通讯作者：
Matthay MA
影响因子：
3.4
作者：
Pappalardo, F;Franco, A;Alfieri, O
通讯作者：
Alfieri, O
影响因子：
18.2
作者：
Raposeiras-Roubin, Sergio;Rodino-Janeiro, Bruno K.;Gonzalez-Juanatey, Jose R.
通讯作者：
Gonzalez-Juanatey, Jose R.
DOI：
10.1097/ta.0b013e3181c40728
发表时间：
2010-05
期刊：
The Journal of trauma
影响因子：
--
作者：
Fremont RD;Koyama T;Calfee CS;Wu W;Dossett LA;Bossert FR;Mitchell D;Wickersham N;Bernard GR;Matthay MA;May AK;Ware LB
通讯作者：
Ware LB
影响因子：
2.2
作者：
Bopp, Christian;Hofer, Stefan;Weigand, Markus A.
通讯作者：
Weigand, Markus A.