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

BMC Pulmonary Medicine

Research Article

Maria T Kuipers¹  Marcus J Schultz¹  Alexander P Vlaar¹  Nicole P Juffermans¹  Pieter R Tuinman²  AB Johan Groeneveld³  Albertus Beishuizen⁴  Alexander D Cornet⁴ 

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

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

DOI  :  10.1186/1471-2466-13-76

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

来源: Springer

【 摘 要 】

BackgroundCardiac 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).MethodsIn 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.ResultsCardiac 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.ConclusionssRAGE 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】

CC BY   
© Tuinman et al.; licensee BioMed Central Ltd. 2013