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Early expression of pro- and anti-inflammatory cytokines in left ventricular assist device recipients with multiple organ failure syndrome.
Early expression of pro- and anti-inflammatory cytokines in left ventricular assist device recipients with multiple organ failure syndrome.
- Source :
-
ASAIO journal (American Society for Artificial Internal Organs : 1992) [ASAIO J] 2010 Jul-Aug; Vol. 56 (4), pp. 313-8. - Publication Year :
- 2010
-
Abstract
- To assess whether the combined evaluation of total Sequential Organ Failure Assessment (t-SOFA) score and pro- and anti-inflammatory cytokine profiles early after left ventricular assist device (LVAD) implant discriminates patients at high risk for multiple organ failure syndrome (MOFS) in the first month post-LVAD, we analyzed plasma interleukin (IL)-6, IL-8, IL-10, IL-1ra, IL-1beta, tumor necrosis factor-alpha (TNF-alpha), and urine neopterin levels before (day 0) and at 4 hours, 1, 3, 7, 14, and 30 days after LVAD implant in 23 recipients. Eight patients died of MOFS between days 7 and 30 (nonsurvivors). At preimplant, only blood urea nitrogen and age were higher in nonsurvivors than survivors. At 4 hours, IL-8, IL-10, and IL1-ra levels were higher in nonsurvivors than in survivors; t-SOFA was also higher and peaked on day 3 in nonsurvivors. Only IL-8 levels on day 1 were significantly associated with a t-SOFA > or =10 on day 3 (odds ratio 1.10, 95% confidence interval 1.01-1.21, p = 0.04). Neopterin, marker of monocyte activation, increased significantly only in nonsurvivors (p < 0.001). These findings suggest that an activated inflammatory system soon after LVAD implant is implicated in MOFS development. Early monitoring of inflammatory mediators and t-SOFA score may be a valuable tool for outcome prediction in LVAD recipients.
- Subjects :
- Adult
Aged
Cytokines immunology
Female
Heart Ventricles
Hemodynamics
Humans
Inflammation blood
Inflammation immunology
Inflammation Mediators blood
Inflammation Mediators immunology
Male
Middle Aged
Multiple Organ Failure immunology
Risk Factors
Severity of Illness Index
Treatment Outcome
Biomarkers blood
Cytokines blood
Heart-Assist Devices
Multiple Organ Failure blood
Subjects
Details
- Language :
- English
- ISSN :
- 1538-943X
- Volume :
- 56
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- ASAIO journal (American Society for Artificial Internal Organs : 1992)
- Publication Type :
- Academic Journal
- Accession number :
- 20445439
- Full Text :
- https://doi.org/10.1097/MAT.0b013e3181de3049