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  • Objective: Pulmonary endarterectomy (PEA) is an effective and potentially curative treatment for chronic thrombo-embolic pulmonary hypertension (CTEPH). The postoperative course after PEA is accompanied by a number of complications, which contribute to the high rate of early postoperative mortality. Markers allowing the early detection of infectious complication during the postoperative period may be of major clinical importance. The aim of the prospective study was to analyse a predictive value of five inflammatory markers to recognise inflammatory complications accompanying PEA before the first clinical signs of infection. Methods: Eighty-two patients with CTEPH, who underwent PEA using cardiopulmonary bypass (CPB) and deep hypothermic circulatory arrest (DHCA), were included into the study. Procalcitonin (PCT), tumour necrosis factor-a, interleukin (IL)-6, IL-8 and C-reactive protein arterial concentrations were measured before sternotomy and repeatedly up to 72 h after the end of surgery. Haemodynamic parameters, infectious and non-infectious complications were recorded. Results: Postoperative course was uncomplicated in 59/82 patients (group 1). Fourteen out of 82 patients (group 2) developed an infection in the first 3 days after surgery (bronchopneumonia, n = 9; bacterial sepsis, n = 5). Nine out of 82 patients (group 3) developed non-infectious complications in the same period. PCT and IL-6 were the only significant independent predictors of infection in days 1-3 after PEA. The area under receiver operating characteristic (ROC) curve calculated for PCT to predict postoperative infection was 0.83 (95% confidence interval (CI): 0.74-0.92) compared with 0.74 (95% CI: 0.68-0.81) for IL-6. With the cut-off 2.3 ng ml(-1), the test characteristics of PCT were as follows: sensitivity, 86%; specificity, 83%; negative predictive value, 92%; and positive predictive value, 84%. Conclusions: The increase in PCT and IL-6 may allow patients at increased risk of infection a
  • Objective: Pulmonary endarterectomy (PEA) is an effective and potentially curative treatment for chronic thrombo-embolic pulmonary hypertension (CTEPH). The postoperative course after PEA is accompanied by a number of complications, which contribute to the high rate of early postoperative mortality. Markers allowing the early detection of infectious complication during the postoperative period may be of major clinical importance. The aim of the prospective study was to analyse a predictive value of five inflammatory markers to recognise inflammatory complications accompanying PEA before the first clinical signs of infection. Methods: Eighty-two patients with CTEPH, who underwent PEA using cardiopulmonary bypass (CPB) and deep hypothermic circulatory arrest (DHCA), were included into the study. Procalcitonin (PCT), tumour necrosis factor-a, interleukin (IL)-6, IL-8 and C-reactive protein arterial concentrations were measured before sternotomy and repeatedly up to 72 h after the end of surgery. Haemodynamic parameters, infectious and non-infectious complications were recorded. Results: Postoperative course was uncomplicated in 59/82 patients (group 1). Fourteen out of 82 patients (group 2) developed an infection in the first 3 days after surgery (bronchopneumonia, n = 9; bacterial sepsis, n = 5). Nine out of 82 patients (group 3) developed non-infectious complications in the same period. PCT and IL-6 were the only significant independent predictors of infection in days 1-3 after PEA. The area under receiver operating characteristic (ROC) curve calculated for PCT to predict postoperative infection was 0.83 (95% confidence interval (CI): 0.74-0.92) compared with 0.74 (95% CI: 0.68-0.81) for IL-6. With the cut-off 2.3 ng ml(-1), the test characteristics of PCT were as follows: sensitivity, 86%; specificity, 83%; negative predictive value, 92%; and positive predictive value, 84%. Conclusions: The increase in PCT and IL-6 may allow patients at increased risk of infection a (en)
Title
  • Predictors of infection after pulmonary endarterectomy for chronic thrombo-embolic pulmonary hypertension
  • Predictors of infection after pulmonary endarterectomy for chronic thrombo-embolic pulmonary hypertension (en)
skos:prefLabel
  • Predictors of infection after pulmonary endarterectomy for chronic thrombo-embolic pulmonary hypertension
  • Predictors of infection after pulmonary endarterectomy for chronic thrombo-embolic pulmonary hypertension (en)
skos:notation
  • RIV/00023001:_____/11:00002509!RIV12-MZ0-00023001
http://linked.open...avai/predkladatel
http://linked.open...avai/riv/aktivita
http://linked.open...avai/riv/aktivity
  • I, P(NR9224), V
http://linked.open...iv/cisloPeriodika
  • 2
http://linked.open...vai/riv/dodaniDat
http://linked.open...aciTvurceVysledku
http://linked.open.../riv/druhVysledku
http://linked.open...iv/duvernostUdaju
http://linked.open...titaPredkladatele
http://linked.open...dnocenehoVysledku
  • 222764
http://linked.open...ai/riv/idVysledku
  • RIV/00023001:_____/11:00002509
http://linked.open...riv/jazykVysledku
http://linked.open.../riv/klicovaSlova
  • Cardiopulmonary bypass; Infection; Inflammatory mediators; Procalcitonin; Surgery complications (en)
http://linked.open.../riv/klicoveSlovo
http://linked.open...odStatuVydavatele
  • NL - Nizozemsko
http://linked.open...ontrolniKodProRIV
  • [AC9AF7D926AC]
http://linked.open...i/riv/nazevZdroje
  • European journal of cardio-thoracic surgery
http://linked.open...in/vavai/riv/obor
http://linked.open...ichTvurcuVysledku
http://linked.open...cetTvurcuVysledku
http://linked.open...vavai/riv/projekt
http://linked.open...UplatneniVysledku
http://linked.open...v/svazekPeriodika
  • 39
http://linked.open...iv/tvurceVysledku
  • Hubáček, Jaroslav
  • Lindner, Jaroslav
  • Maruna, Pavel
  • Klein, Andrew A.
  • Kunstyr, Jan
  • Mlejnsky, František
  • Plocova, Katerina M
http://linked.open...ain/vavai/riv/wos
  • 000287466100010
issn
  • 1010-7940
number of pages
http://bibframe.org/vocab/doi
  • 10.1016/j.ejcts.2010.05.018
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