Markers of inflammation and immunological competence: Assessment in the early postoperative phase of cardiac surgery involving extracorporeal circulation
Abstract
Background
To gain insight into the role and relevance of inflammatory and immunological markers in the comprehensive assessment of a patient’s immune response to surgical procedures. This study focused on investigating preoperative and postoperative serum levels dynamics of SAA, CRP and proportion of HLA-DR CD14 monocytes, CD14 monocytes, and pro-inflammatory monocytes CD16 T CD14 T in patients who underwent heart surgery using extracorporeal circulation (on-pump).
Methods
An observational, prospective study was conducted at the Heart Center of the Clinical Center of the University of Sarajevo on 53 patients divided into 3 age groups: 50-59, 60-69, and 70-80. The serum levels of CRP and SAA were quantitatively determined by immunonephelometry. At the same time, flow cytometry technology was applied to measure the proportion of CD14 monocytes, HLA-DR CD14 monocytes, and pro-inflammatory CD16 CD14 monocytes.
Results
Measured values of CRP; SAA, proportion of monocytes CD14, and proportion of pro-inflammatory monocytes CD16 CD14 are significantly increased postoperatively compared to the preoperative values (p < 0.05). The proportion of HLA-DR CD14 monocytes is lower postoperatively compared to preoperative values (p < 0.001). Furthermore, there are no significant gender differences in the preoperative or postoperative parameters (p > 0.05), with the notable exception of the preoperative proportion of CD14 monocytes (p < 0.05). The analysis of age-related differences indicates no significant changes in the observed preoperative and postoperative parameters among the defined age groups (p >0.05).
Conclusions
Early monitoring of inflammatory and immunological markers in the postoperative phase could be valuable for healthcare professionals to implement prompt interventions to mitigate negative outcomes.