Risk factors of acute respiratory distress syndrome after on-pump cardiac surgery in the INFLACOR cohort study
Loading...
EJTCM_2020_3_1_Kowalik.pdf (375.84 KB)
Date
2020-05-29
Journal Title
Journal ISSN
Volume Title
Publisher
Medical University of Gdańsk
Abstract
Background: Acute respiratory distress syndrome (ARDS) is a serious complication after cardiac surgery with a variety of clinical risk factors. It was hypothesized that genome variants predispose these patients to it. Material and methods: A cohort of 509 adult Caucasians undergoing on-pump cardiac surgery were observed for postoperative ARDS defined by the Berlin definition. Clinical variables and 10 single-nucleotide variants of genes involved in inflammatory pathways were analyzed for associations with four groups, defined by paO2/fiO2 (PF) ratio: 1) no ARDS (PF > 300 mmHg), 2) mild ARDS (200 < PF ≤ 300 mm Hg), 3) moderate ARDS (100 < PF ≤ 200 mm Hg), and 4) severe ARDS (PF ≤ 100 mmHg). Variables remaining in trends at p < 0.05 were considered significant. Results: The prevalence of ARDS was 7.9%. Only LBP rs2232582 remained in a genotypic trend with ARDS aggravation (p = 0.08). Clinical variables associated with ARDS aggravation: impaired left ventricular ejection fraction (p = 0.04), pulmonary hypertension (p = 0.01), intraoperative hypotension (p = 0.009), and postoperative day 1 white blood cell count (p = 0.015). More aggravated ARDS was associated with longer mechanical ventilation (p=0.01) and length of stay in ICU (p = 0.002). Conclusions: The borderline association with LBP rs2232582 and the identified risk factors suggest possible involvement of the LPS-LBP pathway in ARDS of the INFLACOR cohort.
Description
Keywords
Citation
Kowalik MM, Lango R, Łoś A, Chmara M, Brzeziński M, Lewandowski K, Klapkowski A, Rogowski J. Risk factors of acute respiratory distress syndrome after on-pump cardiac surgery in the INFLACOR cohort study. Eur J Transl Clin Med. 2020;3(1):24-33. DOI: 10.31373/ejtcm/122681