• Junichi Saito, Eiji Hashiba, Akio Mikami, Tomoyuki Kudo, Hidetomo Niwa, and Kazuyoshi Hirota.
• Department of Anesthesiology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan. Electronic address: fix-you@hotmail.co.jp.
• J. Cardiothorac. Vasc. Anesth. 2017 Aug 1; 31 (4): 1262-1267.

ObjectiveThe authors investigated the presepsin-concentration profile after cardiac surgery compared with those of procalcitonin (PCT) and C-reactive protein (CRP).DesignA single-center, prospective, observational clinical study.SettingHirosaki University Hospital.ParticipantsPatients who underwent cardiovascular surgery without preoperative infection and end-stage kidney disease requiring dialysis. The patients also were subdivided into 2 groups with respect to the use of cardiopulmonary bypass (CPB).Measurements And Main ResultsPresepsin, PCT, and CRP were measured 4 times: before the induction of anesthesia (baseline), postoperative day (POD) 0, POD 1, and POD 2. Data are expressed as median (25th, 75th interquartiles). A total of 33 patients were examined: 22 patients with CPB and 11 without CPB. For the entire patient series, the presepsin concentrations on POD 0 (220 [166-445] pg/mL), POD 1 (328 [210-581] pg/mL), and POD 2 (310 [202-368] pg/mL) were increased significantly (p < 0.05) compared with baseline (176 [123-275] pg/mL). The PCT and CRP concentrations on POD 1 (0.57 [0.27-1.29] ng/mL and 5.4 [3.1-8.8] mg/dL) and POD 2 (0.64 [0.33-1.43] ng/mL and 11.8 [4.4-17.0] mg/dL) also were increased significantly (p < 0.05) compared with baseline (0.04 [0.03-0.06] ng/mL and 0.07 [0.03-0.22] mg/dL). However, the median concentrations of presepsin up to POD 2 were less than the reported cut-off value (600 pg/mL) to detect infections, whereas those of PCT were above the reported cut-off value (0.5 ng/mL). The increases in presepsin and PCT concentrations were independent of the use of CPB.ConclusionsCardiovascular surgery significantly increased presepsin concentrations, earlier than PCT and CRP.Copyright © 2017 Elsevier Inc. All rights reserved.

25 keywords...

hide…