Hillinger Petra, Mayr Viktoria D, Luger Markus, Tauber Helmuth, Luckner Günter, Morgenthaler Nils G, Dünser Martin, Jochberger Stefan
Department of Anaesthesia and Intensive Care Medicine, University Hospital Innsbruck, Innsbruck, Austria.
Department of Anaesthesia, Landesklinik Hallein, Hallein, Austria.
J Crit Care. 2022 Jun;69:154009. doi: 10.1016/j.jcrc.2022.154009. Epub 2022 Feb 16.
The aim of this study was to analyse the course of adrenomedullin (ADM) and endothelin-1 (ET-1) levels in patients with vasodilatory shock after cardiac surgery and to explore differences compared to patients after uncomplicated coronary artery bypass graft (CABG) surgery. ADM and ET-1 are involved in the vasomotor response during vasodilatory shock.
We included 32 patients with vasodilatory shock (study group) and 10 patients after uncomplicated CABG surgery (control group). Daily measurements of MR-proADM and CT-proET-1 (stable surrogate markers for ADM and ET-1) were collected during the first 7 postoperative days.
MR-proADM and CT-proET-1 levels were significantly elevated in the study group when compared to the control group. In addition, the course of both biomarkers was significantly different in the study versus control group. Higher levels of both biomarkers were associated with organ dysfunction (higher maximum multiple organ dysfunction score, acute kidney injury).
Significantly higher levels of MR-proADM and CT-proET-1 and a different course of both biomarkers were observed in patients with vasodilatory shock after cardiac surgery and seemed to be associated with organ dysfunction.
本研究旨在分析心脏手术后血管舒张性休克患者肾上腺髓质素（ADM）和内皮素-1（ET-1）水平的变化过程，并探讨与单纯冠状动脉旁路移植术（CABG）后患者的差异。ADM和ET-1参与血管舒张性休克期间的血管舒缩反应。
我们纳入了32例血管舒张性休克患者（研究组）和10例单纯CABG术后患者（对照组）。在术后第1个7天内每日测量MR-proADM和CT-proET-1（ADM和ET-1的稳定替代标志物）。
与对照组相比，研究组的MR-proADM和CT-proET-1水平显著升高。此外，研究组与对照组中这两种生物标志物的变化过程存在显著差异。两种生物标志物水平升高均与器官功能障碍相关（更高的最大多器官功能障碍评分、急性肾损伤）。
心脏手术后血管舒张性休克患者的MR-proADM和CT-proET-1水平显著更高，且两种生物标志物的变化过程不同，似乎与器官功能障碍有关。
