Silvetti Simona, Meroni Roberta, Bignami Elena, Bove Tiziana, Landoni Giovanni, Zangrillo Alberto, Bellomo Rinaldo, Pappalardo Federico
Department of Anesthesia and Intensive Care, San Raffaele Scientific Institute, Milano, Italy.
Department of Anesthesia and Intensive Care, San Raffaele Scientific Institute, Milano, Italy.
J Cardiothorac Vasc Anesth. 2014 Apr;28(2):323-7. doi: 10.1053/j.jvca.2013.07.007. Epub 2013 Dec 2.
To investigate the ability of early urinary neutrophil gelatinase-associated lipocalin to predict postoperative complications in adult patients with ventricular dysfunction undergoing cardiac surgery.
Prospective observational study.
Single-center study, university hospital.
Fifty-six adult high-risk cardiac surgical patients with preoperative cardiac failure.
None.
Demographic and clinical characteristics were obtained, and neutrophil gelatinase-associated lipocalin was measured at baseline and at several time points after surgery. Patient characteristics and neutrophil gelatinase-associated lipocalin levels were related to renal and patient outcome. On multivariate analyses, preoperative urinary neutrophil gelatinase-associated lipocalin was an independent predictor of length of intensive care stay (p = 0.004) and in-hospital stay (p = 0.04), but not of acute kidney injury or renal replacement therapy and was not associated with baseline renal function.
In a cohort of high-risk cardiac surgery patients, preoperative urinary neutrophil gelatinase-associated lipocalin value provided prognostic information that was independent of the onset of acute kidney injury or of preoperative renal function.
探讨早期尿中性粒细胞明胶酶相关脂质运载蛋白预测成年心室功能不全患者心脏手术后并发症的能力。
前瞻性观察研究。
单中心研究，大学医院。
56例术前存在心力衰竭的成年高危心脏手术患者。
无。
获取人口统计学和临床特征，并在基线及术后多个时间点测量中性粒细胞明胶酶相关脂质运载蛋白。患者特征及中性粒细胞明胶酶相关脂质运载蛋白水平与肾脏及患者预后相关。多因素分析显示，术前尿中性粒细胞明胶酶相关脂质运载蛋白是重症监护病房住院时间（p = 0.004）和住院时间（p = 0.04）的独立预测因素，但不是急性肾损伤或肾脏替代治疗的预测因素，且与基线肾功能无关。
在一组高危心脏手术患者中，术前尿中性粒细胞明胶酶相关脂质运载蛋白值提供了独立于急性肾损伤发生或术前肾功能的预后信息。
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