Onset of Adverse Abdominal Events Due to Intestinal Ischemia-Reperfusion Injury after Aortic Cross-Clamping Is Associated with Elevated HSP70 Serum Levels in the Early Postoperative Phase
Abstract
:1. Introduction
2. Results
2.1. Persisting Elevation of HSP70 Serum Levels in Patients with Abdominal Complications
2.2. HSP70 Levels as a Biomarker for Abdominal Complications
3. Discussion
Strengths and Limitations
4. Materials and Methods
4.1. Study Design
4.2. Surgery
4.3. HSP70 Measurements
4.4. Endpoints
4.5. Statistics
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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All (n = 21) | No Abdominal Complications (n = 12) | Abdominal Complications (n = 9) | Correlations | |
---|---|---|---|---|
Age (years) | 50.6 ± 12.4 | 51.7 ± 11.3 | 49.1 ± 14.3 | −0.1 (p = 0.65) † |
Women | 6 (28.6) | 3 (25) | 3 (33.3) | 0.67 [0.1–4.48] |
Smoking | 7 (33.3) | 4 (33.3) | 3 (33.3) | 1 [0.16–6.25] |
Obesity | 3 (14.3) | 1 (8.3) | 2 (22.2) | 3.14 [0.24–41.5] |
BMI (m/kg2) | 24.2 ± 4.2 | 24.1 ± 3.7 | 24.4 ± 5 | 0.45 (p = 0.85) † |
COPD | 4 (19) | 2 (16.7) | 2 (22.2) | 1.43 [0.16–12.7] |
Hypertension | 18 (81) | 8 (66.7) | 9 (100) | 0.67 [0.45–0.1] |
CKD | 12 (57.1) | 7 (58.3) | 5 (55.6) | 0.89 [0.16–5.11] |
Prior aortic procedures | 13 (61.9) | 8 (66.7) | 5 (55.6) | 0.63 [0.1–3.7] |
Crawford type | ||||
Type I | 2 (9.5) | 1 (8.3) | 1 (11.1) | 1.375 [0.74–25.43] |
Type II | 7 (33.3) | 3 (25) | 4 (44.4) | 2.4 [0.38–15.32] |
Type III | 7 (33.3) | 5 (41.7) | 2 (22.2) | 0.4 [0.57–2.8] |
Type IV | 5 (23.8) | 3 (25) | 2 (22.2) | 0.86 [0.11–6.62] |
Max. aortic diameter (cm) | 5.8 ± 1.5 | 6.3 ± 1.3 | 5.1 ± 1.5 | −0.4 (p = 0.67) † |
Duration of surgery (min) | 520 ± 89.6 | 490.5 ± 89.7 | 550 ± 85.1 | 0.3 (p = 0.19) † |
Cross-clamping time (min) | 150.6 ± 36.4 | 147.8 ± 41.8 | 155.1 ± 29.5 | 0.1 (p = 0.66) |
All (n = 21) | No Abdominal Complications (n = 12) | Abdominal Complications (n = 9) | Pearson’s r | p-Value | |
---|---|---|---|---|---|
Thirty-day mortality | 4 (19) | 1 (8.3) | 3 (33.3) | 0.32 | 0.164 |
Hospital stay (days) | 44.5 ± 32.7 | 30.9 ± 15.6 | 62.7 ± 41.1 | 0.49 | 0.02 * |
Intensive Care Unit stay (days) | 26.1 ± 25.4 | 17.5 ± 16 | 37.7 ± 31.6 | 0.4 | 0.07 |
Reintervention | 11 (52.4) | 4 (33.3) | 7 (77.8) | 0.44 | 0.046 * |
| 6 (28.6) | 3 (25) | 3 (33.3) | 0.16 | 0.502 |
| 4 (19) | 0 | 4 (44.4) | 0.62 | 0.003 ** |
| 2 (9.5) | 0 | 2 (22.2) | −0.11 | 0.622 |
| 3 (14.3) | 2 (16.6) | 1 (11.1) | −0.04 | 0.863 |
Time to abdominal complications (days) | 4.8 ± 1.3 | ||||
Abdominal complications (total) | 9 (42.9) | 0 (0) | 9 (100) | ||
| 2 (9.5) | 0 (0) | 2 (22.2) | ||
| 2 (9.5) | 0 (0) | 2 (22.2) | ||
| 5 (23.8) | 0 (0) | 5 (55.6) | ||
Postop days to abd. complication (days) | 1.9 ± 3.3 | 0 (0) | 4.4 ± 3.9 | ||
Sepsis | 7 (33.3) | 2 (16.7) | 5 (55.6) | 0.41 | 0.066 |
Multi-organ dysfunction syndrome | 4 (19) | 1 (8.3) | 3 (33.3) | 0.32 | 0.164 |
Acute kidney injury | 13 (61.9) | 6 (50) | 7 (77.8) | 0.28 | 0.214 |
Liver failure | 4 (19) | 1 (8.3) | 3 (33.3) | 0.32 | 0.164 |
Acute respiratory distress syndrome | 9 (42.9) | 4 (33.3) | 5 (55.6) | 0.22 | 0.333 |
Need for catecholamines (days) | 11 ± 10.8 | 6 ± 6.4 | 17.9 ± 12 | 0.56 | 0.013 * |
All (n = 21) | Adjusted p-Value † | No Abdominal Complications (n = 12) | Adjusted p-Value † | Abdominal Complications (n = 9) | Adjusted p-Value † | p-Value †† | |
---|---|---|---|---|---|---|---|
Baseline | 0 [0–0] | 0 [0–0] | 0 [0–0] | 0.92 | |||
Directly postoperative | 11.77 [6.1–20.8] | <0.001 *** | 9.5 [3.9–13.3] | 0.002 ** | 18.3 [9.5–38] | 0.014 * | 0.1 |
12 h | 7.59 [0–14] | 0.002 ** | 0 [0–6.5] | 0.796 | 14.5 [8.8–75.3] | 0.003 ** | 0.007 ** |
24 h | 1.33 [0–5.4] | 0.357 | 0 [0–1.8] | 1 | 6 [0.3–58.9] | 0.526 | 0.15 |
48 h | 0 [0–1.2] | 1 | 0 [0–0] | 1 | 1.2 [0–28] | 1 | 0.06 |
Visceral Malperfusion (n = 5) | p-Value | Abdominal Compartment Syndrome (n = 2) | p-Value | Paralytic Ileus (n = 2) | p-Value | |
---|---|---|---|---|---|---|
baseline | 0.22 | 0.35 | −0.11 | 0.65 | −0.11 | 0.65 |
directly postoperatively | 0.3 | 0.19 | 0.35 | 0.12 | −0.13 | 0.56 |
12 h | 0.43 | 0.05 * | 0.41 | 0.07 | −0.19 | 0.41 |
24 h | 0.3 | 0.22 | 0.08 | 0.75 | −0.36 | 0.12 |
48 h | 0.34 | 0.14 | 0.14 | 0.57 | −0.41 | 0.08 |
AUC | p-Value | Cut-Off | Sensitivity (%) | Specificity (%) | ||
---|---|---|---|---|---|---|
HSP70 (ng/mL) | baseline | 0.556 | 0.68 | 1.2 | 11.1 | 100 |
directly postoperatively | 0.788 | 0.03 * | 14.4 | 66.7 | 83.3 | |
12 h | 0.909 | 0.002 ** | 7.6 | 88.9 | 83.3 | |
24 h | 0.788 | 0.03 * | 3.3 | 66.7 | 100 | |
48 h | 0.808 | 0.02 * | 0.4 | 66.7 | 90.9 | |
Lactate (mmol/L) | baseline | 0.540 | 0.765 | 0.45 | 88.9 | 33.3 |
directly postoperatively | 0.667 | 0.188 | 2.65 | 66.7 | 66.7 | |
12 h | 0.621 | 0.347 | 2.05 | 77.8 | 50 | |
24 h | 0.687 | 0.141 | 1.55 | 77.8 | 78.7 | |
48 h | 0.616 | 0.370 | 1.7 | 33.3 | 90.9 |
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Doukas, P.; Hellfritsch, G.; Krabbe, H.; Frankort, J.; Jacobs, M.J.; Gombert, A.; Simon, F. Onset of Adverse Abdominal Events Due to Intestinal Ischemia-Reperfusion Injury after Aortic Cross-Clamping Is Associated with Elevated HSP70 Serum Levels in the Early Postoperative Phase. Int. J. Mol. Sci. 2022, 23, 15063. https://doi.org/10.3390/ijms232315063
Doukas P, Hellfritsch G, Krabbe H, Frankort J, Jacobs MJ, Gombert A, Simon F. Onset of Adverse Abdominal Events Due to Intestinal Ischemia-Reperfusion Injury after Aortic Cross-Clamping Is Associated with Elevated HSP70 Serum Levels in the Early Postoperative Phase. International Journal of Molecular Sciences. 2022; 23(23):15063. https://doi.org/10.3390/ijms232315063
Chicago/Turabian StyleDoukas, Panagiotis, Gabriel Hellfritsch, Hanif Krabbe, Jelle Frankort, Michael J. Jacobs, Alexander Gombert, and Florian Simon. 2022. "Onset of Adverse Abdominal Events Due to Intestinal Ischemia-Reperfusion Injury after Aortic Cross-Clamping Is Associated with Elevated HSP70 Serum Levels in the Early Postoperative Phase" International Journal of Molecular Sciences 23, no. 23: 15063. https://doi.org/10.3390/ijms232315063