scholarly journals Autologinio kraujo, išsiskyrusio po širdies operacijos, išsaugojimo ir ankstyvos reinfuzijos įvertinimas

2007 ◽  
Vol 5 (3) ◽  
pp. 0-0
Author(s):  
Audronė Veikutienė ◽  
Rimantas Benetis ◽  
Edmundas Širvinskas ◽  
Pranas Grybauskas ◽  
Judita Andrejaitienė ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Blood Loss ◽  
Leucocyte Count ◽  
C Reactive Protein ◽  
Hospital Department ◽  
Allogeneic Transfusion ◽  
Reactive Protein ◽  
Group I ◽  
Group Ii

Audronė Veikutienė1, Rimantas Benetis1, Edmundas Širvinskas2, Pranas Grybauskas3, Judita Andrejaitienė2, Vincentas Veikutis2, Jonas Šurkus41 Kauno medicinos universiteto klinikų Širdies,krūtinės ir kraujagyslių chirurgijos klinika, Eivenių g. 2, LT-50009 Kaunas2 Kauno medicinos universiteto Biomedicininių tyrimų institutas, Eivenių g. 2, LT-50009 Kaunas3 Kauno medicinos universiteto Kardiologijos institutas, Eivenių g. 2, LT-50009 Kaunas4 Kauno medicinos universiteto klinikų Nefrologijos klinika, Eivenių g. 2, LT-50009 KaunasEl paštas: [email protected] Įvadas / tikslas Įvairūs metodai yra siūlomi alogeninio kraujo poreikiui po širdies operacijų sumažinti. Šio darbo tikslas – nustatyti, ar tikslinga naudoti reinfuzijai autologinį kraują, ištekėjusį ankstyvuoju pooperaciniu laikotarpiu, atsižvelgiant į reinfuzijos įtaką ligos pooperacinei eigai. Ligoniai ir metodai Ištirta 90 ligonių, kuriems atliktos širdies operacijos naudojant dirbtinę kraujo apytaką. Tiriamieji suskirstyti į dvi grupes. Pirmą grupę (n = 41) sudarė ligoniai, kuriems po operacijos per 4 valandas į kardiotominį rezervuarą išsiskyręs kraujas buvo surenkamas į sterilius plastikinius maišelius, centrifuguojamas, o gauti autologiniai eritrocitai grąžinami ligoniui. Antros grupės (n = 49) ligoniams išsiskyręs autologinis kraujas nebuvo grąžinamas. Palyginome hemoglobino, hematokrito, leukocitų, C reaktyviojo baltymo vertes prieš operaciją, po operacijos praėjus 4 val., 20 val. ir penktą parą. Tyrėme prokalcitonino koncentraciją serume praėjus 4 val. ir 20 val. po operacijos. Įvertinome netekto kraujo kiekį per 20 val. laikotarpį. Rezultatai Grupių demografiniai, intraoperaciniai duomenys, kairiojo skilvelio išstūmimo frakcija, NYHA funkcinė klasė nesiskyrė. Prieš operaciją ir praėjus 4 val. po operacijos hemoglobino, hematokrito, leukocitų, C reaktyviojo baltymo, prokalcitonino vertės grupėse buvo panašios. Hemoglobino, hematokrito vertės, leukocitų skaičius tarp grupių reikšmingai nesiskyrė ir po 20 val. bei penktą parą. Praėjus 20 val. po operacijos, prokalcitonino koncentracijos padidėjimas (> 0,5–2 ng/ml) dažniau pasitaikė II grupės ligoniams (58,3% / 33,3%). Penktą parą C reaktyviojo baltymo vertė buvo mažesnė I grupėje (70,63 ± 34,23), palyginti su II grupe (93,53 ± 45,48; p < 0,05). Pooperacinis kraujo netekimas per pirmąsias 20 val. tarp grupių reikšmingai nesiskyrė. Alogeninio kraujo transfuzijų poreikis buvo reikšmingai mažesnis I grupės ligoniams: 14,6% / 38,8% (p < 0,05). Infekcinės komplikacijos registruotos I grupės 2,4% ligonių ir II grupės 10,2% ligonių (p < 0,05) Pooperacinio hospitalizavimo trukmė 35,19% buvo trumpesnė I grupės tiriamųjų (p < 0,05). Išvada Ankstyva po širdies operacijos ištekėjusio autologinio, centrifuguoto kraujo reinfuzija nedidino kraujavimo bei sisteminio uždegiminio atsako. Autologinių eritrocitų ankstyvos reinfuzijos grupėje mažėjo alogeninio kraujo transfuzijų poreikis, infekcinių komplikacijų rizika, buvo trumpesnė pooperacinio hospitalizavimo trukmė. Pagrindiniai žodžiai: autologinis kraujas, alogeninis kraujas, dirbtinė kraujo apytaka Benefit of early reinfusion of autologous shed mediastinal blood after cardiac surgery Audronė Veikutienė1, Rimantas Benetis1, Edmundas Širvinskas2, Pranas Grybauskas3, Judita Andrejaitienė2, Vincentas Veikutis2, Jonas Šurkus41 Kaunas University of Medicine Hospital, Department of Cardiothoracic and Vascular Surgery,Eivenių str. 2, LT-50009 Kaunas, Lithuania2 Kaunas University of Medicine, Institute for Biomedical Research,Eivenių str. 2, LT-50009 Kaunas, Lithuania3 Kaunas University of Medicine, Institute of Cardiology,Eivenių str. 2, LT-50009 Kaunas, Lithuania4 Kaunas University of Medicine Hospital, Department of Nefrology,Eivenių str. 2, LT-50009 Kaunas, LithuaniaE-mail: [email protected] Background / objective Various strategies have been proposed to decrease allogeneic transfusion requirements after cardiac surgery. The aim of the study was to evaluate the efficacy of collected and reinfused autologous shed mediastinal blood on the postoperative cource. Patients and methods We investigated 90 patients who underwent cardiac surgery with cardiopulmonary bypass. The patients were divided into two groups: group I (n = 41) received the centrifuged autologous shed mediastinal blood collected from the cardiotomy reservoir following 4 hours after surgery; in group II (n = 49) all shed mediastinal blood was discarded (control group). Haemoglobin, haematocrit, C-reactive protein values, leucocyte count were compared before surgery, 4 h, 20 h after surgery and on the fifth postoperative day. We have measured serum procalcitonin concentration at 4 h and 20 h after cardiopulmonary bypass. We assessed drained blood loss within 20 postoperative hours. Results There were no significant differences in patients’ demographic, operative data, left ventricle ejection fraction, NYHA functional class between the two groups. C-reactive protein, procalcitonin concentration, haemoglobin, haematocrit values, leucocyte count did not differ between the groups before and at 4 hours after surgery. Haemoglobin, haematocrit level, leucocyte count were similar at 20 hours and on the fifth day after surgery. At 20 hours after surgery, an increase of serum procalcitonin concentration (> 0.5–2 ng/ml) was more frequent in group II (58.3% vs 33.3%). On the fifth postoperative day, the C-reactive protein value was lower in group I (70.63 ± 34.23; p < 0.05), compared to group II (93.53 ± 45.48). Postoperative blood loss did not differ between the groups. Requirement for allogeneic transfusion was significantly lower in group I (14.6% vs 38.8%; p < 0.05). Patients in group I developed less infective complications as compared with the group II (2.4% and 10.2%, respectively; p < 0.05). The length of postoperative in-hospital stay was shorter by 35.19% in group I (p < 0.05) as compared with group II. Conclusions Reinfusion of centrifuged autologous shed mediastinal blood did not increase bleeding tendency and systemic inflammatory response. Requirement for allogeneic transfusion, the risk of postoperative infection and the length of postoperative in-hospital stay was lower in autotransfused patients (group I). The estimation of serum procalcitonin concentration is a usable and rather informative test for evaluating inflammatory response activity after cardiac surgery. Key words: autologous blood, allogeneic blood, cardiopulmonary bypass

scholarly journals Method of Enteral Insufficiency Syndrome Correction in Patients with Generalized Peritonitis

2021 ◽  
Vol 14 (3) ◽  
pp. 182-192
Author(s):  
Evgeny A. Korymasov ◽  
Sergey A. Ivanov ◽  
Mariya Kenarskaya ◽  
Maxim U. Khoroshilov
Keyword(s):  
Rating Scale ◽  
Study Groups ◽  
Albumin Level ◽  
C Reactive Protein ◽  
Surgical Interventions ◽  
Reactive Protein ◽  
Generalized Peritonitis ◽  
Group I ◽  
Group Ii ◽  
Insufficiency Syndrome

Introduction. Mortality in generalized peritonitis (GP) reaches 30%, and with the development of multiple organ failure, the lethal outcome is observed in 80-90% of cases. Enteral insufficiency syndrome (EIS) plays a leading role in the progression of generalized peritonitis. The aim of the study was to develop a differentiated approach of enteral insufficiency syndrome correction in patients with generalized peritonitis. Material and methods. This research was a retrospective prospective study. The study included 50 patients with GP, who received treatment at the Surgery Department of the Samara Regional Clinical Hospital in the period from 2017 to 2019. Depending on the chosen treatment tactics, the patients were divided into two clinical groups. Group I included 29 patients, admitted in the period from 2017 to 2018, who had received the standard GP treatment. A long-term endogenous intoxication in patients of this group associated with the progressive enteric failure led to the repeated surgeries; at the same time, a high frequency of postoperative complications was preserved. The analysis of the results in patients of Group I necessitated development of the therapeutic and diagnostic algorithm aimed at early diagnostics and timely correction of EIS. Group II included 21 patients with GP, admitted in the period from 2018 to 2019, who was treated using the new algorithm. Results. The objective criteria for the relief of EIS in GP in patients of the study groups were a decrease in the level of serum albumin and C-reactive protein, a significant decrease in the amount and qualitative change in the intestinal discharge via an intestinal tube, a decrease in the recovery time of the functions of the small intestine and start of defecation. On the 6th postoperative day, in patients of Group II there was no significant albumin level reduction in comparison with the 1st day of monitoring (28.310.77 g/l vs 37.334.69 g/l). Whereas in Group I the albumin level was significantly lower (19.30.51 g/l) than the same parameter in Group II, and in comparison with the 1st day of monitoring (19.30.51 g/l vs 39.56.05 g/l; р = 0.00001). On the 6th postoperative day, the C-reactive protein level differed significantly between the groups as well: Group I 104.7613.49 mg/l, Group II - 58.0029.05 mg/l, p = 0.003. The control of GP in patients of the Group I was reached after 4.52.5 repeated abdominal interventions, while in patients of Group II generalized peritonitis was arrested after 2.30.9 surgical interventions (p = 0.000171), which is 1.9 times less. Conclusions. The proposed algorithm of EIS control is based on the individual approach to the treatment of patients with GP. The developed EIS rating scale allows determining not only the degree and dynamics of the pathological process, but also monitoring the effectiveness of treatment options applied in a particular patient.

scholarly journals Pre-Procedural C-Reactive Protein Level Predicts In-Hospital Outcome in Percutaneous Coronary Intervention

1970 ◽  
Vol 4 (1) ◽  
pp. 32-41 ◽  
Author(s):  
MM Haque ◽  
M Ullah ◽  
MS Alam ◽  
SU Ulabbi ◽  
R Uddin
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Spasm ◽  
Coronary Intervention ◽  
Side Branch ◽  
Major Adverse Cardiovascular Events ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Group I ◽  
Percutaneous Coronary ◽  
Group Ii

Background:To accurately stratify patients undergoing PCI, according to their risk of future adverse events, a quest for risk predictors is ongoing worldwide. But only a few powerful and independent predictors of early and late major adverse cardiovascular events have been found. These include traditional risk factors, such as acute coronary instability, diabetes mellitus, reference vessel diameter, and lesion and/or stent length. This study was undertaken to find out the relationship between pre-procedural CRP level with in-hospital (both procedural and before discharge) complications. Materials & methods: This prospective study was carried out in National Institute of Cardiovascular Diseases (NICVD), Dhaka during the period of June,2006 to May,2007. After fulfilling the exclusion criteria, 100 consecutive patients were selected as sample those underwent percutaneous coronary intervention. C-Reactive protein (CRP) was measured in all patients before the procedure. Those having pre-procedural CRP level <.3 mg/dl was labeled as group-I and those with CRP level e”.3 mg/dl was labeled as group-II. In hospital outcomes were compared between two groups after percutaneous coronary intervention. Results: During the procedure, higher rate of complications (10.0% vs 26.0%) were noted in group- II, which was statistically significant. Among many complications abrupt occlusion, threatened (dissection and new thrombus) and residual stenosis were significantly high in group-II. Other complications like coronary spasm, arrhythmia, side branch occlusion, heart failure, shock and no reflow were also high in higher level of CRP level patients but statistically not significant. Inhospital complications were also significantly high (10.0% vs 28.0%) in patients with higher level of CRP ie. Group-II. Among other complications recurrence of ischemia and myocardial infarction developed at significantly higher rate in group-II. Post procedural CK-MB rose significantly (18.0% vs 36.0%) in patients with higher level of CRP (group-II) in comparison to normal level of CRP patients (group-I). When the in-hospital complications were distributed among three tertiles of CRP, it was observed that complications were proportionately high with increasing level of CRP. Conclusions: Many studies, conducted abroad, have suggested that factors like gender, extreme age, diabetes, multi-vessel disease and lesion characteristics adversely influence PCI outcome. But in this study, multivariate regression analysis has shown that elevated level of CRP is even stronger independent predictor of PCI outcome. Keywords: C-Reactive Protein; In hosital outcome; PCI. DOI: http://dx.doi.org/10.3329/cardio.v4i1.9387 Cardiovasc. J. 2011; 4(1): 32-41

scholarly journals The impact of therapies as monotherapy with combined therapy on novel and traditional biomarkers in patients with rheumatoid arthritis

2020 ◽  
Vol 24 (3) ◽  
pp. 325-332
Author(s):  
Asmaa Haydar ◽  
Ijlal Abdullah
Keyword(s):  
Rheumatoid Arthritis ◽  
Inflammatory Markers ◽  
Combined Therapy ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation ◽  
Group I ◽  
Group Ii ◽  
Citrullinated Protein ◽  
Citrullinated Peptide

Background and objectives: Rheumatoid arthritis is an autoimmune and inflammatory disease that influences many tissues and organs. Inflammatory markers such as C-reactive protein, erythrocyte sedimentation rate, anti-cyclic citrullinated protein, rheumatoid factor, and 14-3-3η protein have been found to play an important role in both the diagnosis and progression of rheumatoid arthritis. This study aimed to elucidate the effect of anti-rheumatoid medication, as mono- and combined therapy, on these inflammatory mediators. Methods: A cross-sectional study was performed at Hawler Medical University, College of Pharmacy, Erbil, Iraq. Forty-two patients of both genders with rheumatoid arthritis participated in the study as group I. Forty-four age–gender matched adults (with no rheumatoid arthritis) were included as a comparison group or group II. Serum levels of biomarkers were determined by enzyme linked immune sorbent assay. Results: There was a statistically significant (P <0.05) increased level of serum anti-cyclic citrullinated peptide, 14-3-3η protein, erythrocyte sedimentation rate, C-reactive protein, and rheumatic factor levels in group I compared with group II. The serum level of the anti-cyclic citrullinated peptide significantly decreased in rheumatoid patients treated with combined therapy compared with mono remedy. However, the mean of body mass index, age, and gender of group I was non-significantly different from group II (P >0.05). Conclusion: Therapeutic regimen of mono or combined therapy played a role in changing levels of inflammatory markers. Anti-cyclic citrullinated protein significantly decreased with the combined therapy in comparison with the monotherapy regimen. Keywords: Rheumatic arthritis; Monotherapy; Combined therapy; Anti-rheumatoid; Inflammatory markers.

Kinetics of procalcitonin, interleukin 6 and C-reactive protein after cardiopulmonary-bypass in children

2003 ◽  
Vol 13 (2) ◽  
pp. 161-167 ◽  
Author(s):  
Maurice Beghetti ◽  
Peter C. Rimensberger ◽  
Afksendiyos Kalangos ◽  
Walid Habre ◽  
Alain Gervaix
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Interleukin 6 ◽  
Early Recognition ◽  
P Value ◽  
Specific Marker ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Valuable Marker ◽  
R Value

Cardiopulmonary bypass induces a generalized inflammatory response, with fever and leukocytes, which is difficult to differentiate from an infection. Recently, procalcitonin has been proposed as an early and specific marker of bacterial infection. The influence of cardiopulmonary bypass on production of procalcitonin, therefore, must be assessed before considering this molecule as a valuable marker of infection after cardiac surgery in children. With this in mind, we measured levels of procalcitonin, interleukin 6, and C-reactive protein before and 6 h, 1, 3 and 5 days after cardiopulmonary bypass, in 25 children undergoing cardiac surgery. Cardiopulmonary-bypass induced a transient increase in procalcitonin, with a peak at 24 h, with a median of 1.13 μg/l, a 25th and 75th interquartile of 0.68–2.25, and a p value of less than 0.001. The value had returned to normal in the majority of the children by the third day after surgery. Peak values correlated with the duration of cardiopulmonary-bypass, with a r-value of 0.58 and a p value of 0.003; cross-clamp time, with a r-value of 0.62 and a p value of 0.001; days of mechanical ventilation, with a r-value of 0.62 and a p value of 0.001; and days of stay in intensive care, with a r-value of 0.68, and a p value of 0.0003. The value returned to normal after 3 days in 83% of the patients. Levels of interleukin 6 and C-reactive protein also increased significantly after surgery, and remained elevated for up to 5 days.Thus, in contrast to other markers, levels of procalcitonin in the serum are only slightly and transiently influenced by cardiopulmonary bypass, and may prove to be useful in the early recognition of an infection subsequent to cardiopulmonary bypass.

scholarly journals Evaluation of Serum C-Reactive Protein Levels in Oral Premalignancies and Malignancies: A Comparative Study

2019 ◽  
Author(s):  
Sairam Vankadara ◽  
Padmaja K ◽  
Praveen Kumar Balmuri ◽  
Naresh G ◽  
Vikas Reddy G
Keyword(s):  
Oral Submucous Fibrosis ◽  
Healthy Controls ◽  
C Reactive Protein ◽  
Group Iii ◽  
Reactive Protein ◽  
Group I ◽  
Increased Risk ◽  
The Mean ◽  
Group Ii ◽  
Risk Of Cancer

Objectives: The aim was to evaluate and compare pretreatment serum C-reactive protein (CRP) levels in patients with oral premalignancies and malignancies with that in healthy controls. Materials and Methods: The study sample consisted of 90 patients of both genders. The subjects were divided into three groups. Group I comprised 30 healthy controls, while group II included 30 patients with potential oral malignancies including leukoplakia, oral submucous fibrosis (OSMF), and oral lichen planus (OLP), and group III included 30 squamous cell carcinoma (SCC) patients confirmed by histopathological examination. All samples were subjected to CRP analysis. Serum CRP levels were quantitatively determined using the automated immunoturbidimetric method. Results: In group I, CRP levels were ranging from 0.1 to 18.3 mg/l with the mean ± standard deviation (SD) CRP level of 3.88±4.50 mg/l. In group II, CRP levels were ranging from 0.8 to 53.9 mg/l with the mean ± SD CRP level of 5.59±9.86 mg/l. In group III, CRP levels were ranging from 3.3 to 96 mg/l with the mean ± SD CRP level of 31.72±31.01 mg/l. Conclusions: According to the results, prediagnostic concentrations of CRP are associated with subsequent development of oral cancer and suggest that plasma CRP level is a potential marker of increased risk of cancer

scholarly journals “Study of Estimation of Cerebrospinal Fluid C-Reactive Protein in Diagnosis of Acute Meningitis.”

2021 ◽  
Vol 8 (4) ◽  
pp. 175-181
Author(s):  
Dr. Keshav Bansal ◽  
◽  
Dr. Dhaval Bhatt ◽  
Dr. Sunil Kumar Dadhich ◽  
Dr. Deep Kariya ◽  
...  
Keyword(s):  
Mean Value ◽  
Latex Agglutination ◽  
C Reactive Protein ◽  
Pyogenic Meningitis ◽  
Group Iii ◽  
Reactive Protein ◽  
Group I ◽  
Diagnostic Role ◽  
Group Ii

Objectives:To assess the diagnostic role of CSF C-reactive protein quantitatively in acute meningitisand to evaluate the efficacy of CSF C-reactive protein in differentiating pyogenic meningitis fromnon-pyogenic meningitis.Material and Methods: It is a prospective observational study of total 102children with suspected meningitis allocated into three groups based on initial investigations; group-I Pyogenic meningitis, group-II Non-Pyogenic meningitis and group-III No meningitis (Controlgroup). Quantitative CSF C-reactive protein was detected by the latex agglutination method. Datawere analyzed to establish the diagnostic role of CSF-CRP and to evaluate the efficacy of CSF-CRP indifferentiating pyogenic meningitis from non-pyogenic meningitis.Results: A total of 102 clinicallysuspected meningitis patients were studied. Based on CSF findings, the study population (102cases) was categorized into 3 groups. Group I was pyogenic meningitis consist 53 cases (51.96%).Group II was Non-Pyogenic meningitis consists 27 cases (26.47%). Group III was normal CSFfindings consist 22 (21.56%). 98.1% cases of pyogenic meningitis had elevated CSF-CRP level >1.1μg/ml of CSF. In the case of Non-Pyogenic meningitis, 96.2% were found to have CSF- CRP in therange of 0.05-0.10 μg/ml. The mean value of CSF-CRP in groups I,II and III were 5.57±1.48,0.09±0.042 and 0.01±0.010 respectively. Conclusion: Detection of CSF-CRP provides a newdimension to establish the diagnosis of pyogenic meningitis. It is a rapid, reliable and sensitivediagnostic test. From this study it is concluded that CSF-CRP can be used to differentiate pyogenicfrom non-pyogenic meningitis. Early, accurate and appropriate therapy can ameliorate the morbidityand mortality rates in such cases.

Increased Serum CRP-Albumin Ratio Is Independently Associated With Severity of Carotid Artery Stenosis

Angiology ◽  
2020 ◽  
Vol 71 (8) ◽  
pp. 740-746 ◽  
Author(s):  
Tarik Yildirim ◽  
Tuncay Kiris ◽  
Eyüp Avci ◽  
Seda ElcimDurusoy Yildirim ◽  
Onur Argan ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Carotid Artery Disease ◽  
Artery Stenosis ◽  
Carotid Angiography ◽  
C Reactive Protein ◽  
Albumin Ratio ◽  
Reactive Protein ◽  
Group I ◽  
Group Ii

Carotid artery stenosis (CAS), mainly caused by carotid atherosclerosis, is related to ischemic stroke. We investigated whether C-reactive protein (CRP) to albumin ratio (CAR) was associated with increased severity of carotid stenosis in patients undergoing carotid angiography. A total of 269 patients who were undergoing carotid angiography were included in this study. The patients were divided into 2 groups with respect to the severe CAS: group 1 (stenosis < 70%, n = 189) or group II (stenosis ≥ 70%, n = 80). C-reactive protein to albumin ratio was higher in group II compared to group I (0.56 ± 0.25 vs 0.14 ± 0.01, P < .001). The CAR (odds ratio [OR]: 1.051, 95%CI: 1.027-1.076, P < .001), neutrophil to lymphocyte ratio (NLR), and total cholesterol levels were independent predictors of severe CAS. The area under the receiver operating characteristic curve (area under the curve) for the CAR to predict severe CAS was 0.798 (95% CI: 0.741-0.854, P < .001). C-reactive to protein albumin ratio was an independent risk factor of severe CAS. Therefore, CAR might be considered a potential index in the severity of carotid artery disease.

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