title: Soluble receptor for advanced glycation end products as an indicator of pulmonary vascular injury after cardiac surgery.
abstract: BACKGROUND
  Cardiac surgery is frequently complicated by an acute vascular lung injury and this may be mediated, at least in part, by the (soluble) receptor for advanced glycation end products (sRAGE).
  
  
  METHODS
  In two university hospital intensive care units, circulating sRAGE was measured together with the 68Gallium-transferrin pulmonary leak index (PLI), a measure of pulmonary vascular permeabiliy, in 60 consecutive cardiac surgery patients stratified by the amount of blood transfusion, within 3 hours of admission to the intensive care.
  
  
  RESULTS
  Cardiac surgery resulted in elevated plasma sRAGE levels compared to baseline (315 ± 181 vs 110 ± 55 pg/ml, P = 0.001). In 37 patients the PLI was elevated 50% above normal. The PLI correlated with sRAGE (r2 = 0.11, P = 0.018). Plasma sRAGE discriminated well between those with an elevated PLI and those with a normal PLI (area under the operator curve 0.75; P = 0.035; 95% CI 0.55-0.95), with 91% sensitivity but low specificity of 36% at a cutoff value of 200 pg/mL. Blood transfusion did not influence sRAGE levels.
  
  
  CONCLUSIONS
  sRAGE is elevated in plasma after cardiac surgery and indicates increased pulmonary vascular permeability. The level of sRAGE is not affected by transfusion.
authors.affiliation: Department of Intensive Care Medicine and Laboratory of Experimental Intensive Care and Anesthesiology (L,E,I,C,A,), Academic Medical Center, Meibergdreef 9, Amsterdam 1105, AZ, The Netherlands. p.r.tuinman@amc.uva.nl.
authors.forename: Pieter R
authors.initials: PR
authors.lastname: Tuinman
authors.forename: Alexander D
authors.initials: AD
authors.lastname: Cornet
authors.forename: Maria T
authors.initials: MT
authors.lastname: Kuipers
authors.forename: Alexander P
authors.initials: AP
authors.lastname: Vlaar
authors.forename: Marcus J
authors.initials: MJ
authors.lastname: Schultz
authors.forename: Albertus
authors.initials: A
authors.lastname: Beishuizen
authors.forename: A B Johan
authors.initials: AB
authors.lastname: Groeneveld
authors.forename: Nicole P
authors.initials: NP
authors.lastname: Juffermans
mesh_terms: D055371:Acute Lung Injury / Q000097:blood* / Q000209:etiology; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D001803:Blood Transfusion; D002199:Capillary Permeability; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008168:Lung / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011446:Prospective Studies; D012372:ROC Curve; D000067759:Receptor for Advanced Glycation End Products; D011971:Receptors, Immunologic / Q000097:blood / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D000067759:Receptor for Advanced Glycation End Products; D011971:Receptors, Immunologic