HLA-DR as a marker for increased risk for systemic inflammation and septic complications after cardiac surgery.
OBJECTIVE
This study investigated the predictive value of a decrease in monocyte HLA-DR expression as an early marker for postoperative SIRS and septic complications. We hypothesized that decreased HLA-DR levels in the first 24 h after cardiac surgery is not related to postoperative SIRS/sepsis. We also compared HLA-DR levels of patients with postoperative complications to those with an uncomplicated course.


METHODS
Prospective observational study in a tertiary care postoperative intensive care unit.


METHODS
Eighty five consecutive patients undergoing cardiac surgery.


RESULTS
Expression of HLA-DR on monocytes was analyzed by flow cytometry using a new quantitative and well standardized technique. Arterial blood samples were collected before induction of anesthesia, immediately after admission to the ICU, and on the first postoperative day. Postoperative HLA-DR expression was significantly decreased in all patients. There were no significant differences in HLA-DR expression during the first 24 h after surgery in patients with uncomplicated course and those developing SIRS or septic complications.


CONCLUSIONS
In patients undergoing cardiac surgery the monitoring of pre- and immediate postoperative HLA-DR levels during the first 24 h does not help to predict increased risk for postoperative SIRS/sepsis or infectious complications.
Oczenski
Wolfgang
W
Department of Anesthesia and Intensive Care and Ludwig Boltzmann Institute for Economics of Medicine in Anesthesia and Intensive Care, City of Vienna Hospital Lainz, Wolkersbergenstrasse 1, 1130, Vienna, Austria. wolfgang.oczenski@khl.magwien.gv.at
Krenn
Herbert
H
Jilch
Ruth
R
Watzka
Herbert
H
Waldenberger
Ferdinand
F
Köller
Ursula
U
Schwarz
Sylvia
S
Fitzgerald
Robert D
RD
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D016022:Case-Control Studies; D005260:Female; D005434:Flow Cytometry; D006684:HLA-DR Antigens / Q000097:blood*; D006801:Humans; D007249:Inflammation / Q000175:diagnosis* / Q000209:etiology / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D018805:Sepsis / Q000175:diagnosis* / Q000209:etiology / Q000276:immunology
D015415:Biomarkers; D006684:HLA-DR Antigens