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Plasma sRAGE enables prediction of acute lung injury following cardiac surgery in children
Critical Care, 06/04/2012
Clinical Article
Liu X et al. – Elevated soluble receptor for advanced glycation end products (sRAGE) and S100A12 levels correlate with impaired lung function, and sRAGE is a useful early biomarker of acute lung injury (ALI) in infants and young children undergoing cardiac surgery.
Methods- Consecutive children aged <3years old following cardiac surgery were prospectively enrolled and assigned into ALI and non-ALI groups according to the American-European Consensus Criteria.
- Plasma concentrations of sRAGE and S100A12 were measured at baseline, before and immediately after CPB, as well as 1h, 12h and 24h after operation.
- Fifty-eight patients were enrolled and 16 (27.6%) developed postoperative ALI.
- Plasma sRAGE and S100A12 levels increased immediately after CPB and kept significantly higher in the ALI group even 24h after operation (P<0.01).
- In addition, a one-way MANOVA revealed that the overall sRAGE and S100A12 levels were higher in the ALI group than in the non-ALI group immediately after CPB (P<0.001).
- The multivariate logistic regression analysis showed that plasma sRAGE level immediately after CPB was an independent predictor for postoperative ALI (OR 1.088, 95%CI 1.011-1.171, P=0.025).
- Increased sRAGE and S100A12 levels immediately after CPB were significantly correlated with lower PaO2/FiO2 ratio (P<0.01) and higher radiographic lung injury score (P<0.01), as well as longer mechanical ventilation time (sRAGEN: r=0.405, P=0.002; S100A12N: r=0.322, P=0.014), longer surgical intensive care unit stay (sRAGEN: r=0.421, P=0.001; S100A12N: r=0.365, P=0.005) and hospital stay (sRAGEN: r=0.329, P=0.012; S100A12N: r=0.471, P=0.001).