Microalbuminuria assessment after thoracic surgery: Early identification of complication risks

Autor: Rossella Potenza, Silvia Ceccarelli, Francesco Puma, Gianpaolo Reboldi, Marco Andolfi, Jacopo Vannucci, Lucio Cagini, Valeria Berti
Přispěvatelé: Cagini L., Andolfi M., Potenza R., Ceccarelli S., Vannucci J., Berti V., Reboldi G., Puma F.
Rok vydání: 2020
Předmět:
Male
Predictive Value of Test
0302 clinical medicine
Early Diagnosi
Immunology and Allergy
postoperative complication
Prospective Studies
030212 general & internal medicine
Prospective cohort study
Lung
Genetics (clinical)
education.field_of_study
Thoracic Surgery
Video-Assisted
Middle Aged
systemic inflammatory response syndrome
albuminuria
perioperative care
postoperative complications
thoracic surgical procedures
Elective Surgical Procedures
Cardiothoracic surgery
thoracic surgical procedure
Creatinine
Anesthesia
Female
Human
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Surgical stress
Thoracic Surgical Procedure
Population
Risk Assessment
03 medical and health sciences
Predictive Value of Tests
medicine
Humans
education
Elective Surgical Procedure
business.industry
Perioperative
medicine.disease
Prospective Studie
Early Diagnosis
030228 respiratory system
Airway Extubation
Microalbuminuria
business
Complication
Capillary Leak Syndrome
Zdroj: The Clinical Respiratory Journal. 14:564-570
ISSN: 1752-699X
1752-6981
DOI: 10.1111/crj.13169
Popis: Introduction: Microalbuminuria (MA) is considered a reflection of systemic capillary leak and an early marker of acute stress reaction to the surgical insult, proportional to the severity of the initiating condition and predictive of the individual response to surgical stress. Objectives: We conducted a prospective study to assess for the variation of MA within 4 days after thoracic surgery. We correlated observed MA levels with both their respective PaO2/FiO2 respiratory ratio and the onset of postoperative complications. Methods: This single-centre study enrolled 255 consecutive patients having an American Society of Anaesthesiologists (ASA)score≤3. The mean age was 62 years with 67% male. All patients were scheduled for elective pulmonary resection. MA was measured in urine samples as the albumin-to-creatinine ratio (A/C), prior to, at and after extubation up to 96 hours. PaO2/FiO2 was measured at extubation and on the first postoperative day. Results: Overall, preoperative A/C levels resulted normal, with a significant average increase at extubation which peaked 6 hours later (P 61mg/g (P=0.0003) was associated with postoperative cardio-pulmonary complications (OR 3.85; P=0.003). Conclusion: Within 6 hours after extubation, MA assessment may be a rapid and relatively inexpensive method for better predicting perioperative risk in an ASA score ≤3 population.
Databáze: OpenAIRE
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