Urinary neutrophil gelatinase-associated lipocalin time course during cardiac surgery.
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Date
2015-01
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Abstract
Background: NGAL is one of the most promising AKI biomarkers in cardiac surgery. However, the
best timing to dose it and the reference values are still matter of discussion. Aim of the Study: We
performed a uNGAL perioperative time course, to better understand its perioperative kinetics and its role
in AKI diagnosis. Setting of the Study: San Raffaele University Hospital, cardiac surgery department.
Material and Methods: We enrolled in this prospective observational study 19 patients undergoing cardiac
surgery with cardiopulmonary bypass (CPB). Based on preoperative characteristics, they were divided in
low-risk and high-risk patients. uNGAL measurements were collected at pre-defined times before, during,
and up to 24 hours after surgery. Statistical Analysis: Data were analysed by use of SAS 1999-2001
program or IBM SPSS Statistics. Results: In low-risk patients, uNGAL had the highest value immediately
after general anesthesia induction (basal dosage: uNGAL: 12.20ng×ml-1, IQR 14.00). It later decreased
significantly (3.40 ng×ml-1, IQR 4.80; P = 0.006) during CPB, and finally return to its original value 24 hours
after surgery. In high-risk patients, uNGAL increased immediately after surgery; it had the highest value on
ICU arrival (38,20 ng×ml-1; IQR 133,10) and remained high for several hours. A difference in uNGAL levels
between the two groups was already observed at the end of surgery, but it became statistically significant
on ICU arrival (P = 0.002). Conclusion: This study helps to better understand the different kinetics of this
new biomarker in low-risk and high-risk cardiac patients.
Description
Keywords
Acute kidney injury, Cardiac surgery, Neutrophil gelatinase‑associated lipocalin
Citation
Bignami Elena, Frati Elena, Meroni Roberta, Simonini Marco, Prima Ambra Licia Di, Manunta Paolo, Zangrillo Alberto. Urinary neutrophil gelatinase-associated lipocalin time course during cardiac surgery. Annals of Cardiac Anaesthesia. 2015 Jan-Mar ; 18(1): 39-44.