Serum Free Fatty Acid Concentration Predicts ARDS after Off-Pump CABG: A Prospective Observational Study.

Autor: Lu P; Department of Cardiovascular Surgery, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taihu Road 366, Taizhou, Jiangsu, 225300, China.; Department of Cardiovascular Surgery, The First Affiliated Hospital With Nanjing Medical University, Nanjing, China., Fan J; Department of Cardiovascular Surgery, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taihu Road 366, Taizhou, Jiangsu, 225300, China., Li X; Department of Cardiovascular Surgery, The First Affiliated Hospital With Nanjing Medical University, Nanjing, China., Liu Z; Department of Cardiovascular Surgery, The First Affiliated Hospital With Nanjing Medical University, Nanjing, China., Qi Y; Department of Cardiovascular Surgery, The First Affiliated Hospital With Nanjing Medical University, Nanjing, China., Shen Z; Department of Cardiovascular Surgery, The First Affiliated Hospital With Nanjing Medical University, Nanjing, China., Wen Z; Department of Cardiovascular Surgery, The First Affiliated Hospital With Nanjing Medical University, Nanjing, China., Yi C; Department of Cardiovascular Surgery, The Affiliated Hospital of Yangzhou University, Yangzhou, China., Song M; Department of Geriatrics, The First Affiliated Hospital With Nanjing Medical University, Nanjing, China. smj1011@126.com., Wang X; Department of Cardiovascular Surgery, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taihu Road 366, Taizhou, Jiangsu, 225300, China. wangxiaowein1@163.com.; Department of Cardiovascular Surgery, The First Affiliated Hospital With Nanjing Medical University, Nanjing, China. wangxiaowein1@163.com.
Jazyk: angličtina
Zdroj: Lung [Lung] 2024 Oct; Vol. 202 (5), pp. 523-532. Date of Electronic Publication: 2024 May 16.
DOI: 10.1007/s00408-024-00704-3
Abstrakt: Background: Free fatty acids (FFAs) are established risk factors for various cardiovascular and metabolic disorders. Elevated FFAs can trigger inflammatory response, which may be associated with the occurrence of acute respiratory distress syndrome (ARDS) in cardiac surgery. In this prospective study, we aimed to investigate the association between circulating FFA and the incidence of ARDS, as well as the length of ICU stay, in patients undergoing off-pump coronary artery bypass grafting (CABG).
Methods: We conducted a single-center, prospective, observational study among patients undergoing off-pump CABG. The primary endpoint was the occurrence of ARDS within 6 days after off-pump CABG. Serum FFA were measured at baseline and 24 h post-procedure, and the difference (Δ-FFA) was calculated.
Results: A total of 180 patients were included in the primary analysis. The median FFA was 2.3 mmol/L (quartile 1 [Q1]-Q3, 1.4-3.2) at baseline and 1.5 mmol/L (Q1-Q3, 0.9-2.3) 24 h after CABG, with a Δ-FFA of 0.6 mmol/L (Q1-Q3, -0.1 to 1.6). Patients with elevated Δ-FFA levels had a significantly higher ARDS occurrence (55.6% vs. 22.2%; P < 0.001). Elevated Δ-FFA after off-pump CABG correlated with a significantly lower PaO 2 /FiO 2 ratio, prolonged mechanical ventilation, and extended length of ICU stay. The area under the curve (AUC) of Δ-FFA for predicting ARDS (AUC, 0.758; 95% confidence interval, 0.686-0.831) significantly exceeded the AUC of postoperative FFA (AUC, 0.708; 95% CI 0.628-0.788; P < 0.001).
Conclusions: Elevated Δ-FFA levels correlated with ARDS following off-pump CABG. Monitoring FFA may assist in identifying high-risk patients for ARDS, facilitating timely interventions to improve clinical outcomes.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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