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Early diagnostic markers of sepsis after oesophagectomy (including thromboelastography)

BACKGROUND: Early diagnosis of sepsis and its differentiation from the noninfective SIRS is very important in order that treatment can be initiated in a timely and appropriate way. In this study we investigated standard haematological and biochemical parameters and thromboelastography (TEG) in patie...

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Autores principales: Durila, Miroslav, Bronský, J, Haruštiak, T, Pazdro, Alexander, Pechová, Marta, Cvachovec, Karel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3458976/
https://www.ncbi.nlm.nih.gov/pubmed/22742451
http://dx.doi.org/10.1186/1471-2253-12-12
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author Durila, Miroslav
Bronský, J
Haruštiak, T
Pazdro, Alexander
Pechová, Marta
Cvachovec, Karel
author_facet Durila, Miroslav
Bronský, J
Haruštiak, T
Pazdro, Alexander
Pechová, Marta
Cvachovec, Karel
author_sort Durila, Miroslav
collection PubMed
description BACKGROUND: Early diagnosis of sepsis and its differentiation from the noninfective SIRS is very important in order that treatment can be initiated in a timely and appropriate way. In this study we investigated standard haematological and biochemical parameters and thromboelastography (TEG) in patients who had undergone surgical resection of the oesophagus to find out if changes in any of these parameters could help in early differentiation between SIRS and sepsis development. METHODS: We enrolled 43 patients (aged 41–74 years) of whom 38 were evaluable. Blood samples were obtained on the morning of surgery and then at 24-hour intervals for the next 6 days. Samples were analysed for procalcitonin (PCT), C-reactive protein (CRP), interleukin-6 (IL- 6), aspartate transaminase (AST), alanine transaminase (ALT) , lactate, white blood count (WBC), D-dimers, antithrombin (AT), international normalised ratio (INR), activated partial thromboplastin time (APTT) and parameters of TEG. RESULTS: Significant differences between patients who developed sepsis during this period (9 patients) and SIRS were found in ALT on Day 1, in AST on Days 1–4, in PCT on Days 2–6; in CRP on Days 3–6; in IL-6 on Days 2–5; in leucocytes on Days 2, 3 and 6; and in D-dimers on Days 2 and 4. Significance values ranged from p < 0.0001 to p < 0.05. CONCLUSIONS: Sequential measurements of ALT, AST, PCT and IL-6 during the early postoperative period can be used for early differentiation of sepsis and postoperative SIRS after oesophagectomy. Among the coagulation parameters measured, only D-dimer concentrations appeared to be helpful in this process. TEG does not seem to be a useful early predictor of sepsis development; however it can be used to differentiate sepsis and SIRS from Day 5 after surgery.
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spelling pubmed-34589762012-09-27 Early diagnostic markers of sepsis after oesophagectomy (including thromboelastography) Durila, Miroslav Bronský, J Haruštiak, T Pazdro, Alexander Pechová, Marta Cvachovec, Karel BMC Anesthesiol Research Article BACKGROUND: Early diagnosis of sepsis and its differentiation from the noninfective SIRS is very important in order that treatment can be initiated in a timely and appropriate way. In this study we investigated standard haematological and biochemical parameters and thromboelastography (TEG) in patients who had undergone surgical resection of the oesophagus to find out if changes in any of these parameters could help in early differentiation between SIRS and sepsis development. METHODS: We enrolled 43 patients (aged 41–74 years) of whom 38 were evaluable. Blood samples were obtained on the morning of surgery and then at 24-hour intervals for the next 6 days. Samples were analysed for procalcitonin (PCT), C-reactive protein (CRP), interleukin-6 (IL- 6), aspartate transaminase (AST), alanine transaminase (ALT) , lactate, white blood count (WBC), D-dimers, antithrombin (AT), international normalised ratio (INR), activated partial thromboplastin time (APTT) and parameters of TEG. RESULTS: Significant differences between patients who developed sepsis during this period (9 patients) and SIRS were found in ALT on Day 1, in AST on Days 1–4, in PCT on Days 2–6; in CRP on Days 3–6; in IL-6 on Days 2–5; in leucocytes on Days 2, 3 and 6; and in D-dimers on Days 2 and 4. Significance values ranged from p < 0.0001 to p < 0.05. CONCLUSIONS: Sequential measurements of ALT, AST, PCT and IL-6 during the early postoperative period can be used for early differentiation of sepsis and postoperative SIRS after oesophagectomy. Among the coagulation parameters measured, only D-dimer concentrations appeared to be helpful in this process. TEG does not seem to be a useful early predictor of sepsis development; however it can be used to differentiate sepsis and SIRS from Day 5 after surgery. BioMed Central 2012-06-28 /pmc/articles/PMC3458976/ /pubmed/22742451 http://dx.doi.org/10.1186/1471-2253-12-12 Text en Copyright ©2012 Durila et al.;licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Durila, Miroslav
Bronský, J
Haruštiak, T
Pazdro, Alexander
Pechová, Marta
Cvachovec, Karel
Early diagnostic markers of sepsis after oesophagectomy (including thromboelastography)
title Early diagnostic markers of sepsis after oesophagectomy (including thromboelastography)
title_full Early diagnostic markers of sepsis after oesophagectomy (including thromboelastography)
title_fullStr Early diagnostic markers of sepsis after oesophagectomy (including thromboelastography)
title_full_unstemmed Early diagnostic markers of sepsis after oesophagectomy (including thromboelastography)
title_short Early diagnostic markers of sepsis after oesophagectomy (including thromboelastography)
title_sort early diagnostic markers of sepsis after oesophagectomy (including thromboelastography)
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3458976/
https://www.ncbi.nlm.nih.gov/pubmed/22742451
http://dx.doi.org/10.1186/1471-2253-12-12
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