• Jonas Holm, Zoltán Szabó, Urban Alehagen, Tomas L Lindahl, and Ingemar Cederholm.
• Department of Cardiothoracic Surgery and Anesthesia and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden. Electronic address: jonas.holm@liu.se.
• J. Cardiothorac. Vasc. Anesth. 2018 Feb 1; 32 (1): 245-250.

ObjectiveTo describe the dynamics of copeptin in open cardiac surgery during the perioperative course.DesignProspective cohort study.SettingSingle tertiary hospital.ParticipantsTwenty patients scheduled for open cardiac surgery procedures with cardiopulmonary bypass (CPB).InterventionsNo intervention.Measurements And Main ResultsCopeptin concentrations were measured pre-, peri-, and postoperatively until day 6 after surgery. Patients were analyzed as a whole cohort (n = 20) and in a restricted "normal cohort" consisting of patients with normal preoperative copeptin concentration (<10 pmol/L) and perioperative uneventful course (n = 11). In the whole cohort, preoperative copeptin concentration was 7.0 pmol/L (interquartile range: 3.1-11 pmol/L). All patients had an early rise of copeptin, with 80% having peak copeptin concentration at weaning from CPB or upon arrival in the intensive care unit. Patients in the "normal cohort" had copeptin concentration at weaning from CPB of 194 pmol/L (98-275), postoperative day 1, 27 pmol/L (18-31); and day 3, 8.9 pmol/L (6.3-12).ConclusionsRegardless of cardiac surgical procedure and perioperative course, all patients had an early significant rise of copeptin concentrations, generally peaking at weaning from CBP or upon arrival in the intensive care unit. Among patients with normal copeptin concentration preoperatively and uneventful course, the postoperative copeptin concentrations decreased to normal values within 3-to-4 days after cardiac surgery. Furthermore, the restricted "normal cohort" generally tended to display lower levels of copeptin concentration postoperatively. Further studies may evaluate whether copeptin can be a tool in identifying risk patients in cardiac surgery.Copyright © 2018 Elsevier Inc. All rights reserved.

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