title: HLA-DR as a marker for increased risk for systemic inflammation and septic complications after cardiac surgery.
abstract: 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.
authors.affiliation: 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
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Oczenski
authors.forename: Herbert
authors.initials: H
authors.lastname: Krenn
authors.forename: Ruth
authors.initials: R
authors.lastname: Jilch
authors.forename: Herbert
authors.initials: H
authors.lastname: Watzka
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Waldenberger
authors.forename: Ursula
authors.initials: U
authors.lastname: Köller
authors.forename: Sylvia
authors.initials: S
authors.lastname: Schwarz
authors.forename: Robert D
authors.initials: RD
authors.lastname: Fitzgerald
mesh_terms: 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
chemical_list: D015415:Biomarkers; D006684:HLA-DR Antigens