Acute Lung Injury After Cardiac Surgery: Pathogenesis

Study Overview
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Brief Summary
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The purpose of the present study is to visualize the inflammatory response and coagulation disorders during cardiac surgery in order to identify possible predictors for acute lung injury postoperatively.

Detailed Description
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Acute lung injury after cardiac surgery is a common complication. The pathophysiology is complex and still not fully elucidate. No specific biomarkers are identified and the diagnosis is solely based on impaired oxygenation. The purpose of the present study is to identify biomarkers of inflammation and coagulation in blood withdrawn simultaneous from the pulmonary artery and the left atrium during surgery and up to 20 hours after weaning from cardiopulmonary bypass.

Official Title
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Acute Lung Injury After Cardiac Surgery: Pathogenesis

Conditions
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Acute Lung Injury, Metabolic Disturbances, Inflammation, Coagulation; Intravascular, Postoperative; Dysfunction Following Cardiac Surgery

Intervention / Treatment
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* Other: No intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Elective surgery CABG In treatment with statins Exclusion Criteria: Acute surgery Valve replacement In treatment with immunodepressive drugs

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 90 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: No intervention|No treatment|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Acute lung injury measured as the fraction of partial pressure of oxygen divided by the fraction of inspired oxygen | Arterial blood gas analysis | Evaluated 72 hours after weaning from cardiopulmonary bypass (CPB) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Interleukin-1beta | Measured in blood samples from radial artery, pulmonary artery and left atrium | The day before surgery; the day of surgery with measurement just before connecting to , immediately after weaning from CPB, 2, 4, 8, 16 and 20 hours after weaning from CPB; and exactly 48 and 72 hours after weaning from CPB | 
| Interleukin-2 | Measured in blood samples from radial artery, pulmonary artery and left atrium | The day before surgery; the day of surgery with measurement just before connecting to , immediately after weaning from CPB, 2, 4, 8, 16 and 20 hours after weaning from CPB; and exactly 48 and 72 hours after weaning from CPB | 
| Interleukin-4 | Measured in blood samples from radial artery, pulmonary artery and left atrium | The day before surgery; the day of surgery with measurement just before connecting to , immediately after weaning from CPB, 2, 4, 8, 16 and 20 hours after weaning from CPB; and exactly 48 and 72 hours after weaning from CPB | 
| Interleukin-6 | Measured in blood samples from radial artery, pulmonary artery and left atrium | The day before surgery; the day of surgery with measurement just before connecting to , immediately after weaning from CPB, 2, 4, 8, 16 and 20 hours after weaning from CPB; and exactly 48 and 72 hours after weaning from CPB | 
| Interleukin-8 | Measured in blood samples from radial artery, pulmonary artery and left atrium | The day before surgery; the day of surgery with measurement just before connecting to , immediately after weaning from CPB, 2, 4, 8, 16 and 20 hours after weaning from CPB; and exactly 48 and 72 hours after weaning from CPB | 
| Interleukin-10 | Measured in blood samples from radial artery, pulmonary artery and left atrium | The day before surgery; the day of surgery with measurement just before connecting to , immediately after weaning from CPB, 2, 4, 8, 16 and 20 hours after weaning from CPB; and exactly 48 and 72 hours after weaning from CPB | 
| Tumor necroting factor-alpha | Measured in blood samples from radial artery, pulmonary artery and left atrium | The day before surgery; the day of surgery with measurement just before connecting to , immediately after weaning from CPB, 2, 4, 8, 16 and 20 hours after weaning from CPB; and exactly 48 and 72 hours after weaning from CPB | 
| Interferon-gamma | Measured in blood samples from radial artery, pulmonary artery and left atrium | The day before surgery; the day of surgery with measurement just before connecting to , immediately after weaning from CPB, 2, 4, 8, 16 and 20 hours after weaning from CPB; and exactly 48 and 72 hours after weaning from CPB | 
| Granulocyte-macrophage colony-stimulating factor | Measured in blood samples from radial artery, pulmonary artery and left atrium | The day before surgery; the day of surgery with measurement just before connecting to , immediately after weaning from CPB, 2, 4, 8, 16 and 20 hours after weaning from CPB; and exactly 48 and 72 hours after weaning from CPB | 
| Thrombin-antithrombin complexes | Measured in blood samples from pulmonary artery and left atrium | The day before surgery; the day of surgery with measurement just before connecting to , immediately after weaning from CPB, 2, 4, 8, 16 and 20 hours after weaning from CPB | 
| Plasmin-antiplasmin complexes | Measured in blood samples from pulmonary artery and left atrium | The day before surgery; the day of surgery with measurement just before connecting to , immediately after weaning from CPB, 2, 4, 8, 16 and 20 hours after weaning from CPB | 
| D-dimer | Measured in blood samples from pulmonary artery and left atrium | The day before surgery; the day of surgery with measurement just before connecting to , immediately after weaning from CPB, 2, 4, 8, 16 and 20 hours after weaning from CPB | 
| Thrombin Fragment 1.2 | Measured in blood samples from pulmonary artery and left atrium | The day before surgery; the day of surgery with measurement just before connecting to , immediately after weaning from CPB, 2, 4, 8, 16 and 20 hours after weaning from CPB | 
| Metabolomics | Metabolomics using the NMR-technique in blood samples from radial artery, pulmonary artery and left atrium | The day before surgery; the day of surgery with measurement just before connecting to , immediately after weaning from CPB, 2, 4, 8, 16 and 20 hours after weaning from CPB; and exactly 48 and 72 hours after weaning from CPB |