title: Urinary neutrophil gelatinase-associated lipocalin time course during cardiac surgery.
abstract: BACKGROUND
  NGAL is one of the most promising AKI biomarkers in cardiac surgery. However, the best timing to dose it and the reference values are still matter of discussion.
  
  
  OBJECTIVE
  We performed a uNGAL perioperative time course, to better understand its perioperative kinetics and its role in AKI diagnosis.
  San Raffaele University Hospital, cardiac surgery department.
  
  
  METHODS
  We enrolled in this prospective observational study 19 patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Based on preoperative characteristics, they were divided in low-risk and high-risk patients. uNGAL measurements were collected at pre-defined times before, during, and up to 24 hours after surgery.
  
  
  METHODS
  Data were analysed by use of SAS 1999-2001 program or IBM SPSS Statistics.
  
  
  RESULTS
  In low-risk patients, uNGAL had the highest value immediately after general anesthesia induction (basal dosage: uNGAL: 12.20ng×ml -1 , IQR 14.00). It later decreased significantly (3.40 ng×ml -1 , IQR 4.80; P = 0.006) during CPB, and finally return to its original value 24 hours after surgery. In high-risk patients, uNGAL increased immediately after surgery; it had the highest value on ICU arrival (38,20 ng×ml -1 ; IQR 133,10) and remained high for several hours. A difference in uNGAL levels between the two groups was already observed at the end of surgery, but it became statistically significant on ICU arrival (P = 0.002).
  
  
  CONCLUSIONS
  This study helps to better understand the different kinetics of this new biomarker in low-risk and high-risk cardiac patients.
authors.affiliation: Department of Cardiothoracic Anaesthesia and Intensive Care, San Raffaele Hospital, Milan, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Bignami
authors.forename: Elena
authors.initials: E
authors.lastname: Frati
authors.forename: Roberta
authors.initials: R
authors.lastname: Meroni
authors.forename: Marco
authors.initials: M
authors.lastname: Simonini
authors.forename: Ambra Licia
authors.initials: AL
authors.lastname: Di Prima
authors.forename: Paolo
authors.initials: P
authors.lastname: Manunta
authors.forename: Alberto
authors.initials: A
authors.lastname: Zangrillo
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis* / Q000652:urine*; D000209:Acute-Phase Proteins / Q000652:urine*; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000652:urine; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D005260:Female; D006438:Hemodilution; D006801:Humans; D000071068:Lipocalin-2; D054834:Lipocalins / Q000652:urine*; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D011183:Postoperative Complications / Q000175:diagnosis* / Q000652:urine*; D011446:Prospective Studies; D011518:Proto-Oncogene Proteins / Q000652:urine*; D012306:Risk
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins