Urinary biomarkers to predict severe fluid overload after cardiac surgery: a pilot study

2021 ◽  
Author(s):  
Saban Elitok ◽  
Berend Isermann ◽  
Sabine Westphal ◽  
Prasad Devarajan ◽  
Christian Albert ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Pilot Study ◽  
Intensive Care Unit Admission ◽  
Fluid Overload ◽  
Predictive Ability ◽  
Urinary Biomarkers ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Reactive Protein

Aim: To assess the predictive ability of urinary and plasma biomarkers and clinical routine parameters for subsequent severe fluid overload. Patients & methods: In a pilot study, we studied 100 adult patients after cardiac surgery. On intensive care unit admission, we measured biomarkers in urine (midkine, IL-6, neutrophil gelatinase-associated lipocalin [NGAL], hepcidin-25) and plasma (creatinine, urea, B-type natriuretic peptide, lactate, C-reactive protein, leukocytes, IL-6, NGAL, hepcidin-25) to predict postoperative severe fluid overload. Results: Urinary midkine, IL-6, NGAL and hepcidin-25 (all AUCs ≥0.79) predicted postoperative severe fluid overload (N = 5 patients). Urinary NGAL/hepcidin-25 ratio (AUC 0.867) predicted postoperative severe fluid overload after adjustment to EuroScore and need for norepinephrine on surgery day (odds ratio: 2.4). Conclusion: Urinary biomarkers on intensive care unit admission might be helpful to predict subsequent severe fluid overload after cardiac surgery.

scholarly journals Intensive Care Unit Admission Parameters Improve the Accuracy of Operative Mortality Predictive Models in Cardiac Surgery

PLoS ONE ◽  
2010 ◽  
Vol 5 (10) ◽  
pp. e13551 ◽  
Author(s):  
Marco Ranucci ◽  
Andrea Ballotta ◽  
Serenella Castelvecchio ◽  
Ekaterina Baryshnikova ◽  
Simonetta Brozzi ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Intensive Care Unit Admission ◽  
Predictive Models ◽  
Operative Mortality

Neutrophil gelatinase-associated lipocalin is a better biomarker than cystatin C for the prediction of imminent acute kidney injury in critically ill patients

2017 ◽  
Vol 55 (2) ◽  
pp. 190-197 ◽  
Author(s):  
Itir Yegenaga ◽  
Fatih Kamis ◽  
Canan Baydemir ◽  
Elizade Erdem ◽  
Koray Celebi ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Intensive Care Unit Admission ◽  
Cystatin C ◽  
Kidney Injury ◽  
Failure Criteria ◽  
Serum Cystatin C ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Neutrophil Gelatinase

Aims The prevention of acute kidney injury can be lifesaving for the intensive care unit patients. However, conventional methods are not sufficient for the prediction of the risk of future acute kidney injury. In this study, the promising biomarker, neutrophil gelatinase-associated lipocalin, was compared with cystatin C as an indicator for the risk of future acute kidney injury. Methods One hundred and eighty-three adult patients without chronic kidney disease or renal replacement therapy were included in this study. The plasma and urine concentrations of neutrophil gelatinase-associated lipocalin and cystatin C were assessed on the second day after intensive care unit admission and were followed for seven days to monitor the development of acute kidney injury. Acute kidney injury diagnosis was based on the risk, injury, failure, loss, end-stage renal failure criteria. Results Thirty-four per cent of the patients had acute kidney injury; 17 patients who did not fulfil criteria at the beginning, developed acute kidney injury from days 3 to 7 after admission. The mean serum creatinine on admission did not significantly differ between this and control groups (0.72 ± 0.20 and 0.83 ± 0.21; P = 0.060); however, the serum and urinary neutrophil gelatinase-associated lipocalin concentrations on the second day were significantly different (median: 75.69 [54.18–91.18] and 123.68 [90.89–166.31], P = 0.001; and median: 17.60 [8.56–34.04] and 61.37 [24.59–96.63], P = 0.001). Notably, the 48-h serum cystatin C concentration did not differ. Conclusion Neutrophil gelatinase-associated lipocalin concentrations in the urine and serum on the second day of intensive care unit admission could be used to predict the development of acute kidney injury in the following three to seven days in the intensive care unit; however, the cystatin C concentration did not have predictive value.

Mortality Prediction After Cardiac Surgery: Higgins’ Intensive Care Unit Admission Score Revisited

2020 ◽  
Vol 110 (5) ◽  
pp. 1589-1594
Author(s):  
Lars Engerström ◽  
Wolfgang Freter ◽  
Johan Sellgren ◽  
Folke Sjöberg ◽  
Mats Fredrikson ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Intensive Care Unit Admission ◽  
Mortality Prediction
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