title: Urinary neutrophil gelatinase-associated lipocalin as an early predictor of prolonged intensive care unit stay after cardiac surgery.
abstract: Neutrophil gelatinase-associated lipocalin (NGAL) is a protein of lipocalin family highly expressed in various pathologic states and is an early biomarker of acute kidney injury in cardiac surgery. We performed an observational study to evaluate the role of NGAL in predicting postoperative intensive care stay in high-risk patients undergoing cardiac surgery. We enrolled 27 consecutive patients who underwent high-risk cardiac surgery with cardiopulmonary bypass. Urinary NGAL (uNGAL) was measured before surgery, at intensive care unit (ICU) arrival and 24 h later. Univariate and multivariate predictors of ICU stay were performed. uNGAL was 18.0 (8.7-28.1) ng/mL at baseline, 10.7 (4.35-36.0) ng/mL at ICU arrival and 29.6 (9.65-29.5) 24 h later. The predictors of prolonged ICU stay at the multivariate analysis were body mass index (BMI), uNGAL 24 h after surgery, and aortic cross-clamp time. The predictors of high uNGAL levels 24 h after at a multivariate analysis were preoperative uNGAL and logistic European System for Cardiac Operative Risk Evaluation. At a multivariate analysis the only independent predictors of prolonged ICU stay were BMI, uNGAL 24 h after surgery and aortic cross-clamp time.
authors.affiliation: Department of Anaesthesia and Intensive Care, Università Vita-Salute San Raffaele, Milano, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Bignami
authors.forename: Elena
authors.initials: E
authors.lastname: Frati
authors.forename: Ferruccio
authors.initials: F
authors.lastname: Ceriotti
authors.forename: Rita
authors.initials: R
authors.lastname: Daverio
authors.forename: Simona
authors.initials: S
authors.lastname: Silvetti
authors.forename: Giovanni
authors.initials: G
authors.lastname: Landoni
authors.forename: Giovanni
authors.initials: G
authors.lastname: Marino
authors.forename: Alberto
authors.initials: A
authors.lastname: Zangrillo
mesh_terms: D000209:Acute-Phase Proteins / Q000502:physiology / Q000652:urine*; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D006348:Cardiac Surgical Procedures; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D000071068:Lipocalin-2; D054834:Lipocalins / Q000502:physiology / Q000652:urine*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011518:Proto-Oncogene Proteins / Q000502:physiology / Q000652:urine*
chemical_list: D000209:Acute-Phase Proteins; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins