The effect of heparins on plasma concentration of heparin-binding protein: a pilot study.
| Autor: | Halldorsdottir H; Department of Clinical Sciences, Division of Anaesthesia and Intensive Care, Karolinska Institutet, Danderyd Hospital, Danderyd, Sweden.; Department of Physiology and Pharmacology, Section of Anaesthesiology and Intensive Care, Karolinska Institutet, Stockholm, Sweden., Lindbom L; Department of Physiology and Pharmacology, Section of Anaesthesiology and Intensive Care, Karolinska Institutet, Stockholm, Sweden., Ebberyd A; Department of Physiology and Pharmacology, Section of Anaesthesiology and Intensive Care, Karolinska Institutet, Stockholm, Sweden., Oldner A; Department of Physiology and Pharmacology, Section of Anaesthesiology and Intensive Care, Karolinska Institutet, Stockholm, Sweden.; Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden., Weitzberg E; Department of Physiology and Pharmacology, Section of Anaesthesiology and Intensive Care, Karolinska Institutet, Stockholm, Sweden.; Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden. |
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| Jazyk: | angličtina |
| Zdroj: | BJA open [BJA Open] 2024 Jan 27; Vol. 9, pp. 100256. Date of Electronic Publication: 2024 Jan 27 (Print Publication: 2024). |
| DOI: | 10.1016/j.bjao.2023.100256 |
| Abstrakt: | Background: Neutrophil-derived heparin-binding protein (HBP) plays a role in the pathophysiology of impaired endothelial dysfunction during inflammation. HBP has been suggested as a predictor of organ dysfunction and disease progression in sepsis. We investigated the effects of heparins on plasma concentrations of HBP in patients undergoing surgery. Methods: We studied three groups of patients receiving heparins during or after surgery. The vascular surgery group received 3000-7500 U, whereas the cardiac surgery group received 27 500-40 000 U. After major general surgery, the third group received 5000 U of low-molecular-weight heparin (LMWH) subcutaneously. Serial plasma HBP concentrations were measured after these treatments with two different methods: Axis-Shield ELISA and Joinstar FIC-Q100. In addition, plasma myeloperoxidase and syndecan-1 were measured in the cardiac surgery group. Results: During vascular surgery, heparin induced a six-fold increase in HBP within 2 min, from 3.6 (2.4-5.4) to 21.4 (9.0-35.4) ng ml -1 ( P <0.001). During cardiac surgery, the higher dose of heparin elevated HBP concentrations from 5.3 (2.7-6.1) to 48.7 (38.4-70.1) ng ml -1 ( P <0.0001) within 3 min. Patients receiving LMWH showed an increase from a baseline of 5.7 (3.7-12.1) ng ml -1 to a peak HBP concentration of 14.8 (9.5-18.1) ng ml -1 ( P <0.0001) after 3 h. Plasma concentrations of myeloperoxidase, but not syndecan-1, also responded with a rapid increase after heparin. There was a strong correlation between the two methods for HBP analysis ( r =0.94). Conclusions: Plasma concentrations of HBP increased rapidly and dose-dependently after heparin administration. Subcutaneous administration of LMWH increases plasma HBP, but to a lesser degree. Clinical Trial Registration: ClinicalTrials.gov identifier: NCT04146493. (© 2023 The Authors.) |
| Databáze: | MEDLINE |
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