Soluble receptor for advanced glycation end products as an indicator of pulmonary vascular injury after cardiac surgery

BMC Pulmonary Medicine

Nicole P Juffermans³  AB Johan Groeneveld¹  Albertus Beishuizen⁴  Marcus J Schultz³  Alexander P Vlaar³  Maria T Kuipers³  Alexander D Cornet⁴  Pieter R Tuinman² 

[1] Department of Intensive Care Medicine, Erasmus MC, 's-Gravendijkwal 230, Rotterdam 3015, CE, The Netherlands;Department of Intensive Care Medicine, Academic Medical Center, Room G3-227, Meibergdreef 9, 1105, AZ Amsterdam, the Netherlands;Department of Intensive Care Medicine and Laboratory of Experimental Intensive Care and Anesthesiology (L.E.I.C.A.), Academic Medical Center, Meibergdreef 9, Amsterdam 1105, AZ, The Netherlands;Department of Intensive Care Medicine, VU University Medical Center, De Boeleaan 1117, Amsterdam 1081, HZ, The Netherlands

关键词: Pulmonary leakage index;    ARDS;    Acute lung injury;    Critically ill;    Transfusion;    Cardiac surgery;    sRAGE;   

Others  :  865462
DOI  :  10.1186/1471-2466-13-76

 received in 2013-03-29, accepted in 2013-12-05,  发布年份 2013

【 摘 要 】

Background

Cardiac surgery is frequently complicated by an acute vascular lung injury and this may be mediated, at least in part, by the (soluble) receptor for advanced glycation end products (sRAGE).

Methods

In two university hospital intensive care units, circulating sRAGE was measured together with the ⁶⁸Gallium-transferrin pulmonary leak index (PLI), a measure of pulmonary vascular permeabiliy, in 60 consecutive cardiac surgery patients stratified by the amount of blood transfusion, within 3 hours of admission to the intensive care.

Results

Cardiac surgery resulted in elevated plasma sRAGE levels compared to baseline (315 ± 181 vs 110 ± 55 pg/ml, P = 0.001). In 37 patients the PLI was elevated 50% above normal. The PLI correlated with sRAGE (r² = 0.11, P = 0.018). Plasma sRAGE discriminated well between those with an elevated PLI and those with a normal PLI (area under the operator curve 0.75; P = 0.035; 95% CI 0.55-0.95), with 91% sensitivity but low specificity of 36% at a cutoff value of 200 pg/mL. Blood transfusion did not influence sRAGE levels.

Conclusions

sRAGE is elevated in plasma after cardiac surgery and indicates increased pulmonary vascular permeability. The level of sRAGE is not affected by transfusion.

【 授权许可】

   
2013 Tuinman et al.; licensee BioMed Central Ltd.

【 图 表 】

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