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Prolonged Systemic Inflammatory Response Syndrome After Cardiac Surgery.
Emma Viikinkoski1, Jenni Aittokallio1, Joonas Lehto1
1Heart Center, Turku University Hospital and University of Turku, Turku, Finland.
Journal of Cardiothoracic and Vascular Anesthesia
|January 14, 2024
Summary
Systemic inflammatory response syndrome (SIRS) after cardiac surgery predicts poor outcomes. Preoperative nerve growth factor and interleukin 5 levels can identify patients at risk for prolonged SIRS, enabling early intervention for better patient results.
Area of Science:
- Cardiology
- Immunology
- Surgical Outcomes
Background:
- Cardiac surgery frequently triggers a systemic inflammatory response syndrome (SIRS), increasing patient morbidity and mortality.
- Current methods lack individualized predictors for adverse outcomes or specific biomarkers for excessive inflammation post-cardiac surgery.
Purpose of the Study:
- To determine if SIRS criteria can predict postoperative outcomes beyond infection and sepsis.
- To investigate if exaggerated inflammatory responses can be identified preoperatively.
Main Methods:
- An observational study prospectively enrolled 261 patients undergoing cardiac surgery with cardiopulmonary bypass.
- Patients were monitored for 90 days post-surgery, with preoperative biomarker profiling conducted.
- Systemic inflammatory response syndrome (SIRS) was assessed using defined criteria over consecutive postoperative days.
Main Results:
- Prolonged SIRS (≥2 criteria for 4 consecutive days) occurred in 6.4% of patients.
- Prolonged SIRS significantly predicted postoperative atrial fibrillation (POAF), 90-day stroke, and mortality.
- Preoperative nerve growth factor and interleukin 5 levels were associated with prolonged SIRS.
Conclusions:
- Nerve growth factor and interleukin 5 show potential as biomarkers for predicting prolonged SIRS.
- Identifying patients with prolonged SIRS preoperatively can help anticipate and potentially mitigate risks of POAF, stroke, and mortality.
