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Intensive Care Medicine

, 26:S193 | Cite as

Procalcitonin in patients undergoing cardiopulmonary bypass in open heart surgery—first results of the Procalcitonin in Heart Surgery study (ProHearts)

  • M. Loebe
  • S. Locziewski
  • F. M. Brunkhorst
  • C. Harke
  • R. Hetzer
Original

Abstract

Objective

To investigate procalcitonin (PCT) levels in patients undergoing cardiopulmonary bypass (CPB) in order to assess the prevalence and prognostic capacity of elevated PCT levels following CPB in open heart surgery.

Design

prospective observational study in consecutive patients.

Setting

Twenty-four-bed ICU, department of thoracic and cardiovascular surgery, university hospital.

Patients

Seven hundred and twenty two patients, 691 of whom underwent CPB, i.e., 476 had coronary bypass surgery (CABG), 130 valve replacement, 34 combined CABG and valve replacement and 23 thoracic aortic surgery.

Interventions

Standard perfusion techniques were used with cardioplegic arrest and mild hypothermia (28–32°C). With the exception of thoracic aortic procedures, full-flow perfusion was performed.

Measurements and results

PCT was measured prior to surgery and daily thereafter until ICU discharge or death. PCT significantly increased at day 1 postoperatively compared to baseline values (0.25±1.65 vs 6.49±22.0 ng/ml, p<0.005). However, in 55.1% of patients PCT was below 1.0 ng/ml. In 12.8% of CABG patients PCT was increased to >5.0 ng/ml, compared to 39% in valve patients and 35% of patients with aortic surgery. An elevated PCT level >1.0–5.0 ng/ml at day 1 was highly predictive of mortality (P<0.03, vs<1.0 ng/ml), with an additional accuracy when levels >5.0 ng/ml were measured (P<0.002 vs<1.0 ng/ml).

Conclusions

These results provide evidence that PCT might serve as an early prognostic marker in patients undergoing CPB in open heart surgery. It may be worth considering immunomodulating approaches in patients presenting elevated PCT levels in the early phase after CPB.

Key words

Cardiopulmonary Coronary artery bypass graft Valve surgery Thoracic aortic surgery Prognosis Hypotension Systemic inflammatory response syndrome (SIRS) Procalcitonin Endotoxin 

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Copyright information

© Springer-Verlag 2000

Authors and Affiliations

  • M. Loebe
    • 1
  • S. Locziewski
    • 1
  • F. M. Brunkhorst
    • 2
  • C. Harke
    • 1
  • R. Hetzer
    • 1
  1. 1.Department of Thoracic and Cardiovascular SurgeryDeutsches Herzzentrum BerlinBerlinGermany
  2. 2.Department of Intensive Care Medicine and CardiologyBehring KrankenhausBerlinGermany

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