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Mirosław Bitner, Dariusz Nowak, Ryszard Jaszewski, Agata Sarniak, Andrzej Walczak
Med Sci Tech 2008; 49(4): RA219-222
ID: 881621
Introduction: Study to evaluate effect of cardio-pulmonary by-pass (CPB) on organs prone to damage during the procedure. C-reactive protein (CRP) is non-specific indicator of systemic inflammatory response (SIRS) connected with CPB. Material and methods: 26 patients, 21-78 year old, 9 female, 17 male, 15 with aortic, 11 with mitral valve diseases, 22 in NYHA III, 4 in NYHA class IV, with LVEF 56.5 ± 5.8% (44-66%) randomly chosen from 332 consecutive patients (117 mitral, 215 aortic) admitted for operation. Excluding criteria: smoking, pulmonary diseases; left ventricle, kidney, or liver insufficiency; history of stroke; inability to co-operate; obesity, emergency and re-operations. CRP was measured before the operation (CRP0), on postoperative day 1 (POD1), POD2, and before discharge, on POD9 on average (CRP1, CRP2, and CRP7 respectively). Results: CRP0 ranged from 0.82 to 75.4; 9.88±15.15 mg/L on average (twice the highest normal level = 5 mg/L), however 13 patients had it normal. CRP1 was tenfold, CRP2 – eighteen fold, and CRP7 - fivefold higher than CRP0. They differed significantly to each other (p< 0.001). There were no correlations between CRP0, its increase after the operation, kind of disease, aortic cross clamp time, mechanical ventilation period, need for catecholamine support, FA occurrence, or pulmonary complications. Conclusions: In half a number of acquired mitral and aortic valve diseases CRP is significantly increased. After CPB it rises by many folds with its peak on the POD 2. However this remains in homeostasis ability range and cannot be a predictor of clinically visible complications of any kind. (Clin Exp Med Lett 2008; 49(4): 219-222)
Keywords: Systemic Inflammatory Response Syndrome, complications, cardio-pulmonary by-pass