Serum Free Fatty Acid Concentration Predicts ARDS after Off-Pump CABG: A Prospective Observational Study

Area of Science:

• Cardiology
• Pulmonology
• Metabolic Disorders

Background:

• Free fatty acids (FFAs) are recognized risk factors for cardiovascular and metabolic diseases.
• Elevated FFAs can induce inflammation, potentially contributing to acute respiratory distress syndrome (ARDS) in cardiac surgery patients.

Purpose of the Study:

• To investigate the association between circulating FFAs and ARDS incidence.
• To examine the relationship between FFAs and intensive care unit (ICU) length of stay.
• To analyze these associations in patients undergoing off-pump coronary artery bypass grafting (CABG).

Main Methods:

• A prospective, single-center, observational study was conducted.
• Serum FFAs were measured at baseline and 24 hours post-procedure, calculating the difference (Δ-FFA).
• The primary endpoint was ARDS occurrence within 6 days after off-pump CABG.

Main Results:

• Patients with elevated Δ-FFA showed significantly higher ARDS occurrence (55.6% vs. 22.2%, P < 0.001).
• Increased Δ-FFA correlated with lower PaO2/FiO2 ratio, prolonged mechanical ventilation, and extended ICU stay.
• Δ-FFA demonstrated superior predictive capability for ARDS (AUC, 0.758) compared to postoperative FFA (AUC, 0.708).

Conclusions:

• Elevated Δ-FFA levels are associated with ARDS development after off-pump CABG.
• Monitoring FFA changes may aid in identifying patients at high risk for ARDS.
• Timely interventions guided by FFA monitoring could improve clinical outcomes.