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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.

Authors :
Caruso R
Trunfio S
Milazzo F
Campolo J
De Maria R
Colombo T
Parolini M
Cannata A
Russo C
Paino R
Frigerio M
Martinelli L
Parodi O
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.

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