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Title: Prognostic value of biomarkers after cardiopulmonary bypass in pediatrics: The prospective PANCAP study
Author: Bobillo Pérez, Sara
Jordán García, Iolanda
Corniero Alonso, Patricia
Balaguer Gargallo, Mònica
Solé Ribalta, Anna
Esteban, Maria Esther
Esteban Torné, Elisabeth
Cambra Lasaosa, Francisco José
Keywords: Marcadors bioquímics
Derivació cardiopulmonar
Biochemical markers
Cardiopulmonary bypass
Issue Date: 17-Jun-2019
Publisher: Public Library of Science (PLoS)
Abstract: Objective:To assess the usefulness of procalcitonin, pro-adrenomedullin and pro-atrial natriuretic peptide as predictors of need for mechanical ventilation and postoperative complications (need for inotropic support and bacterial infection) in critically ill pediatric patients after cardiopulmonary bypass. Design:A prospective, observational study Setting: Pediatric intensive care unit. Patients: Patients under 18 years old admitted after cardiopulmonary bypass. Measuraments and main results: Serum levels of procalcitonin, pro-adrenomedullin and pro-atrial natriuretic peptide were determined immediately after bypass and at 24-36 hours. Their values were correlated with the need for mechanical ventilation, inotropic support and bacterial infection. One hundred eleven patients were recruited. Septal defects (30.6%) and cardiac valve disease (17.1%) were the most frequent pathologies. 40.7% required mechanical ventilation, 94.6% inotropic support and 15.3% presented invasive bacterial infections. Pro-adrenomedullin and pro-atrial natriuretic peptide showed significant high values in patients needing mechanical ventilation. Cut-off values higher than 1.22 nmol/L and 215.3 pmol/L, respectively for each biomarker, may indicate need for mechanical ventilation with an AUC of 0.721 and 0.746 at admission and 0.738 and 0.753 at 24-36 hours, respectively but without statistical differences. Pro-adrenomedullin and procalcitonin showed statistically significant high values in patients with bacterial infections. Conclusions: After bypass, pro-adrenomedullin and pro-atrial natriuretic peptide are suitable biomarkers to predict the need for mechanical ventilation. Physicians should be alert if the values of these markers are high so as not to progress to early extubation. Procalcitonin is useful for predicting bacterial infection. This is a preliminary study and more clinical studies should be done to confirm the value of pro-adrenomedullin and pro-atrial natriuretic peptide as biomarkers after cardiopulmonary bypass.
Note: Reproducció del document publicat a:
It is part of: PLoS One, 2019, vol. 14, num. 6, p. e0215690
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ISSN: 1932-6203
Appears in Collections:Articles publicats en revistes (Institut de Recerca de la Biodiversitat (IRBio))
Articles publicats en revistes (Biologia Evolutiva, Ecologia i Ciències Ambientals)
Articles publicats en revistes (Cirurgia i Especialitats Medicoquirúrgiques)

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