Cargando…

Acute systemic inflammatory response after cardiac surgery in patients infected with human immunodeficiency virus using clinical and inflammatory markers

BACKGROUND: Immediate post-cardiopulmonary bypass (CPB) immune responses and organ injuries in immune-compromised patients remain poorly documented. METHOD: Sixty-one consecutive patients (30 HIV seropositive and 31 seronegative), undergoing elective cardiac valve(s) replacement were enrolled, from...

Descripción completa

Detalles Bibliográficos
Autores principales: Gojo, Mawande KE, Prakaschandra, Rosaley
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Makerere Medical School 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5656216/
https://www.ncbi.nlm.nih.gov/pubmed/29085399
http://dx.doi.org/10.4314/ahs.v17i3.14
_version_ 1783273675631362048
author Gojo, Mawande KE
Prakaschandra, Rosaley
author_facet Gojo, Mawande KE
Prakaschandra, Rosaley
author_sort Gojo, Mawande KE
collection PubMed
description BACKGROUND: Immediate post-cardiopulmonary bypass (CPB) immune responses and organ injuries in immune-compromised patients remain poorly documented. METHOD: Sixty-one consecutive patients (30 HIV seropositive and 31 seronegative), undergoing elective cardiac valve(s) replacement were enrolled, from a single center hospital, after informed consent was obtained. C-reactive protein (CRP) and Erythrocyte sedimentation rate (ESR) were used as biomarkers of acute inflammatory response. RESULTS: The mean age was similar between the HIV seropositive and negative group. Pre-operatively, CRP (p=0.388) and ESR (p=0.817) were comparable. The CPB events and durations were significantly different between the two groups: duration (p=0.021), clamp aortic duration (p=0.026), bloodtransfusion (p=0.013), total urine output (p=0.035) and peak lactate (p=0.040). Post-operatively, there was significant increased biomarkers level in both groups, albeit not between the groups with a significant negative correlation between the mean change in CRP levels and mechanical ventilation (r=0.548, p=0.002) in the seropositive group (r=0.025, p=0.893). The correlation between pre-operative and post-operative difference in CRP and ICU stay was not significant in both groups. A significant drop (p=<0.001) in CD4 cells was documented post-operatively in the HIV seropositive group. CONCLUSION: HIV positive patients' post-operative reactions to cardiac surgery supported by CPB are similar to those of HIV seronegative patients.
format Online
Article
Text
id pubmed-5656216
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher Makerere Medical School
record_format MEDLINE/PubMed
spelling pubmed-56562162017-10-30 Acute systemic inflammatory response after cardiac surgery in patients infected with human immunodeficiency virus using clinical and inflammatory markers Gojo, Mawande KE Prakaschandra, Rosaley Afr Health Sci Articles BACKGROUND: Immediate post-cardiopulmonary bypass (CPB) immune responses and organ injuries in immune-compromised patients remain poorly documented. METHOD: Sixty-one consecutive patients (30 HIV seropositive and 31 seronegative), undergoing elective cardiac valve(s) replacement were enrolled, from a single center hospital, after informed consent was obtained. C-reactive protein (CRP) and Erythrocyte sedimentation rate (ESR) were used as biomarkers of acute inflammatory response. RESULTS: The mean age was similar between the HIV seropositive and negative group. Pre-operatively, CRP (p=0.388) and ESR (p=0.817) were comparable. The CPB events and durations were significantly different between the two groups: duration (p=0.021), clamp aortic duration (p=0.026), bloodtransfusion (p=0.013), total urine output (p=0.035) and peak lactate (p=0.040). Post-operatively, there was significant increased biomarkers level in both groups, albeit not between the groups with a significant negative correlation between the mean change in CRP levels and mechanical ventilation (r=0.548, p=0.002) in the seropositive group (r=0.025, p=0.893). The correlation between pre-operative and post-operative difference in CRP and ICU stay was not significant in both groups. A significant drop (p=<0.001) in CD4 cells was documented post-operatively in the HIV seropositive group. CONCLUSION: HIV positive patients' post-operative reactions to cardiac surgery supported by CPB are similar to those of HIV seronegative patients. Makerere Medical School 2017-09 /pmc/articles/PMC5656216/ /pubmed/29085399 http://dx.doi.org/10.4314/ahs.v17i3.14 Text en Copyright © Makerere Medical School, Uganda 2017 @ 2017 Gojo et al; licensee African Health Sciences. This is an Open Access article distributed under the terms of the Creative commons Attribution License (https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Articles
Gojo, Mawande KE
Prakaschandra, Rosaley
Acute systemic inflammatory response after cardiac surgery in patients infected with human immunodeficiency virus using clinical and inflammatory markers
title Acute systemic inflammatory response after cardiac surgery in patients infected with human immunodeficiency virus using clinical and inflammatory markers
title_full Acute systemic inflammatory response after cardiac surgery in patients infected with human immunodeficiency virus using clinical and inflammatory markers
title_fullStr Acute systemic inflammatory response after cardiac surgery in patients infected with human immunodeficiency virus using clinical and inflammatory markers
title_full_unstemmed Acute systemic inflammatory response after cardiac surgery in patients infected with human immunodeficiency virus using clinical and inflammatory markers
title_short Acute systemic inflammatory response after cardiac surgery in patients infected with human immunodeficiency virus using clinical and inflammatory markers
title_sort acute systemic inflammatory response after cardiac surgery in patients infected with human immunodeficiency virus using clinical and inflammatory markers
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5656216/
https://www.ncbi.nlm.nih.gov/pubmed/29085399
http://dx.doi.org/10.4314/ahs.v17i3.14
work_keys_str_mv AT gojomawandeke acutesystemicinflammatoryresponseaftercardiacsurgeryinpatientsinfectedwithhumanimmunodeficiencyvirususingclinicalandinflammatorymarkers
AT prakaschandrarosaley acutesystemicinflammatoryresponseaftercardiacsurgeryinpatientsinfectedwithhumanimmunodeficiencyvirususingclinicalandinflammatorymarkers