title: Ischemia-modified albumin and adenosine plasma concentrations are associated with severe systemic inflammatory response syndrome after cardiopulmonary bypass.
abstract: OBJECTIVE
  Severe systemic inflammatory response syndrome (SIRS) occurring after cardiopulmonary bypass (CPB) is a common cause of mortality during cardiac surgery. These syndromes are characterized by vasoplegia and ischemia-reperfusion phenomenom. Adenosine is a strong endogenous vasodilating agent, which may be involved in blood pressure failure during CPB induced by severe SIRS. Ischemia-modified albumin (IMA) is considered as a sensitive marker of tissue ischemia. We examined whether the IMA or adenosine plasma concentrations (APCs) change during a severe SIRS-induced blood pressure failure during CPB.
  
  
  METHODS
  Plasma concentration and IMA (median [range]) were measured before, during, and after surgery in 86 patients who underwent coronary revascularization under CBP and were correlated to postoperative clinical course.
  
  
  RESULTS
  Preoperative APC values (1.45 [0.52-2.11] μmol L(-1) vs 0.36 [0.12-0.66] μmol L(-1)) and IMA (144 [91-198] IU mL(-1) vs 109 [61-183] U mL(-1)) were significantly increased in patients presenting postoperative severe SIRS. Mean durations of mechanical ventilation, stay in the intensive care unit, and requirement of vasoactive drugs were significantly higher in patients with higher APC and IMA, but APC was the best predictive marker a postoperative severe.
  
  
  CONCLUSIONS
  Adenosine plasma concentration and IMA concentration are associated with postoperative severe SIRS after CPB.
authors: Pôle d'Anesthésie-Réanimation, Groupe Hospitalier de La Timone, Marseille, Cedex 05, France; UMR MD2, Aix-Marseille University (AMU), Marseille, France.
authors: Laetitia
authors: L
authors: Nee
authors: Roch
authors: R
authors: Giorgi
authors: Vlad
authors: V
authors: Garibaldi
authors: Laurie
authors: L
authors: Bruzzese
authors: Dorothée
authors: D
authors: Blayac
authors: Julien
authors: J
authors: Fromonot
authors: Nathalie
authors: N
authors: Kipson
authors: Maurice
authors: M
authors: Bellezza
authors: Pierre Jean
authors: PJ
authors: Lejeune
authors: Régis
authors: R
authors: Guieu
authors: François
authors: F
authors: Kerbaul
mesh_terms: D000241:Adenosine / Q000097:blood*; D000368:Aged; D000418:Albumins / Q000378:metabolism*; D000758:Anesthesia / Q000379:methods; D015415:Biomarkers / Q000097:blood; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D003327:Coronary Disease / Q000601:surgery*; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood* / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy
chemical_list: D000418:Albumins; D015415:Biomarkers; D000241:Adenosine
keywords: Adenosine; Ischemia-modified albumin; SIRS