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The Dynamics of Heparin-Binding Protein in Cardiothoracic Surgery—A Pilot Study

Sterner, Niklas ; Fisher, Jane LU ; Thelaus, Louise LU ; Ketteler, Carolin ; Lemež, Špela ; Dardashti, Alain LU ; Nilsson, Johan LU orcid ; Linder, Adam LU and Zindovic, Igor LU (2021) In Journal of Cardiothoracic and Vascular Anesthesia 35(9). p.2640-2650
Abstract

Objectives: To explore the preoperative, intraoperative, and postoperative dynamics of heparin-binding protein (HBP) in cardiothoracic surgery. Design: This was a prospective, observational study. Setting: The study was conducted at a single university hospital. Participants: Thirty patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) were included, 15 of whom underwent coronary artery bypass grafting surgery and 15 of whom underwent complex procedures. Ten patients undergoing lung surgery also were included as a conventional surgery reference group. Interventions: No interventions were performed. Measurements and Main Results: HBP was measured at nine different perioperative times. HBP levels increased immediately... (More)

Objectives: To explore the preoperative, intraoperative, and postoperative dynamics of heparin-binding protein (HBP) in cardiothoracic surgery. Design: This was a prospective, observational study. Setting: The study was conducted at a single university hospital. Participants: Thirty patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) were included, 15 of whom underwent coronary artery bypass grafting surgery and 15 of whom underwent complex procedures. Ten patients undergoing lung surgery also were included as a conventional surgery reference group. Interventions: No interventions were performed. Measurements and Main Results: HBP was measured at nine different perioperative times. HBP levels increased immediately after heparin administration, further increased during CPB, but decreased rapidly after protamine administration. At arrival to the intensive care unit, median HBP levels were 24.8 (15.6-38.1) ng/mL for coronary artery bypass grafting patients and 51.2 (34.0-117.7) ng/mL for complex surgery patients (p = 0.011). One day after surgery, HBP levels in all three groups were below the proposed cutoff of 30 ng/mL, which previously was found to predict development of organ dysfunction in patients with infection. Conclusions: HBP levels are elevated by the administration of heparin and the use of CPB but reduced by protamine administration. At postoperative day one, HBP levels were less than the threshold for organ dysfunction in patients with infection. The usefulness of HBP for predicting postoperative infections in cardiothoracic surgery should be investigated in future studies.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
biomarker, cardiopulmonary bypass, cardiothoracic surgery, heparin-binding protein, postoperative infections
in
Journal of Cardiothoracic and Vascular Anesthesia
volume
35
issue
9
pages
11 pages
publisher
Elsevier
external identifiers
  • scopus:85099459663
  • pmid:33454168
ISSN
1053-0770
DOI
10.1053/j.jvca.2020.12.033
language
English
LU publication?
yes
id
98941876-3190-4a0b-a2ba-85d116049bb1
date added to LUP
2021-01-28 11:36:28
date last changed
2024-04-03 23:16:05
@article{98941876-3190-4a0b-a2ba-85d116049bb1,
  abstract     = {{<p>Objectives: To explore the preoperative, intraoperative, and postoperative dynamics of heparin-binding protein (HBP) in cardiothoracic surgery. Design: This was a prospective, observational study. Setting: The study was conducted at a single university hospital. Participants: Thirty patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) were included, 15 of whom underwent coronary artery bypass grafting surgery and 15 of whom underwent complex procedures. Ten patients undergoing lung surgery also were included as a conventional surgery reference group. Interventions: No interventions were performed. Measurements and Main Results: HBP was measured at nine different perioperative times. HBP levels increased immediately after heparin administration, further increased during CPB, but decreased rapidly after protamine administration. At arrival to the intensive care unit, median HBP levels were 24.8 (15.6-38.1) ng/mL for coronary artery bypass grafting patients and 51.2 (34.0-117.7) ng/mL for complex surgery patients (p = 0.011). One day after surgery, HBP levels in all three groups were below the proposed cutoff of 30 ng/mL, which previously was found to predict development of organ dysfunction in patients with infection. Conclusions: HBP levels are elevated by the administration of heparin and the use of CPB but reduced by protamine administration. At postoperative day one, HBP levels were less than the threshold for organ dysfunction in patients with infection. The usefulness of HBP for predicting postoperative infections in cardiothoracic surgery should be investigated in future studies.</p>}},
  author       = {{Sterner, Niklas and Fisher, Jane and Thelaus, Louise and Ketteler, Carolin and Lemež, Špela and Dardashti, Alain and Nilsson, Johan and Linder, Adam and Zindovic, Igor}},
  issn         = {{1053-0770}},
  keywords     = {{biomarker; cardiopulmonary bypass; cardiothoracic surgery; heparin-binding protein; postoperative infections}},
  language     = {{eng}},
  month        = {{09}},
  number       = {{9}},
  pages        = {{2640--2650}},
  publisher    = {{Elsevier}},
  series       = {{Journal of Cardiothoracic and Vascular Anesthesia}},
  title        = {{The Dynamics of Heparin-Binding Protein in Cardiothoracic Surgery—A Pilot Study}},
  url          = {{http://dx.doi.org/10.1053/j.jvca.2020.12.033}},
  doi          = {{10.1053/j.jvca.2020.12.033}},
  volume       = {{35}},
  year         = {{2021}},
}