Time Course of CD64, a Leukocyte Activation Marker, During Cardiopulmonary Bypass Surgery
| Autor: | Karim Zouaoui Boudjeltia, Philippe Cauchie, Anne Daper, Emmanuel Fossé, Sarah Djebara, Patrick Biston, Christophe Lelubre, Michaël Piagnerelli, Marc Joris |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Population 030204 cardiovascular system & hematology Critical Care and Intensive Care Medicine Gastroenterology law.invention Sepsis 03 medical and health sciences 0302 clinical medicine law Internal medicine medicine Cardiopulmonary bypass Humans Prospective Studies education Aged CD64 education.field_of_study Cardiopulmonary Bypass Interleukin-6 Tumor Necrosis Factor-alpha Septic shock business.industry Interleukin-8 Receptors IgG 030208 emergency & critical care medicine Middle Aged medicine.disease Interleukin-12 Shock Septic Interleukin-10 Surgery Cardiac surgery Intensive Care Units C-Reactive Protein Cytokine Shock (circulatory) Emergency Medicine Female medicine.symptom business Biomarkers |
| Zdroj: | Shock. 47:158-164 |
| ISSN: | 1073-2322 |
| DOI: | 10.1097/shk.0000000000000751 |
| Popis: | Distinction between inflammation secondary to surgery, especially coronary artery bypass graft with cardiopulmonary bypass (CPB), and inflammation due to infection is difficult in surgical intensive care unit (ICU) patients. Development of biomarkers of infection could help clinicians in the early identification and thus treatment of sepsis in these patients. We compared the time course of the neutrophil CD64 index, a high affinity immunoglobulin FC γ receptor I whose expression is increased in bacterial infection, in 39 patients undergoing cardiac surgery with CPB and 11 patients admitted to the ICU with severe sepsis or septic shock. The CD64 index was significantly more elevated in septic patients than in patients who had CPB except at day 5. The CD64 index increased moderately on day 1 after cardiac surgery but the value remained lower than in septic patients. The duration for which the CD64 index was greater than 1.0 was longer in septic than in CPB patients. Receiver operating curves to differentiate CPB from sepsis on day 1 were not significantly different between C-reactive protein (CRP) concentrations and CD 64 index. Nevertheless, combination of low CD64 index with low CRP concentrations on day 1 ruled out sepsis except in three patients. There were no correlations between the CD64 index and cytokine levels (tumor necrosis factor [TNF]-α, interferon [IFN]γ, interleukin [IL]-6, IL-10, IL-8, IL-12) measured in subpopulations. In conclusion, CD64 index only in combination with CRP concentrations could be used to discriminate inflammation due to surgery from that due to infection in this particular population. |
| Databáze: | OpenAIRE |
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