Aris ÇAKİRİS, Ulaş KUMBASAR, Cem BOSTAN, Ali Can HATEMİ, Duran USTEK, Kadir ÇEVİKER, Aysem KAYA

Effects of Phosphorylcholine-Coated Circuits On Neutrophil Gelatinase-Associated Lipocalin (Ngal) Levels In Coronary Artery Bypass Grafting

Amaç: Fosforil kolin kaplı kardiyopulmoner bypass devrelerinin renal fonksiyonlar üzerine olan etkisinin kreati- nin gibi standart serum belirteçleriyle saptanması mümkün değildir. Biz çalışmamızda, koroner arter bypass cerra- hisi uygulanan hastalarda, kaplı olmayan ve fosforil kolin kaplı olan kardiyopulmoner bypass devrelerinin inflama- tuar cevap ve renal fonksiyonlar üzerine olan etkilerini serum Nötrofil Jelatinaz İlişkili Lipokalin (NGAL) ölçümle- ri ile karşılaştırdık.Yöntem ve Gereçler: Kırkiki hasta rastgele olarak iki gruba ayırıldı (Fosforil kolin kaplı, n=17 ve kontrol, n=15).Bulgular: Preoperatif veya postoperatif kırmızı kan hücreleri, beyaz kan hücreleri, kreatinin seviyesi, kan üre azo- tu seviyesi ve C-reaktif protein seviyesi açısından iki grup arasında farklılık kaydedilmedi. Preoperatif NGAL sevi- yeleri benzerdi. Her iki grupta da peroperatif NGAL seviyesinde artış görüldü ancak anlamlı kabul edilmedi.SerumNGAL seviyeleri postoperatif 6. günde gruplar arasında anlamlı fark oluşturacak şekilde düşüş gösterdi (Fosforil ko- lin kaplı: 183.1 ± 123 ng/dl, kontrol: 265.2 ± 144 ng/dl, p=0.028). Postoperatif 1. haftada her iki grupta da NGAL se- viyeleri benzerdi. Sonuç: Bu çalışmada, fosforil kolin kaplı devrelerde daha düşük NGAL seviyeleri bulundu ve bu durum renal fonksi- yonlarda standart serum belirteçleri ile belirlenemeyecek bir iyileşme ile ilişkilendirildi.

Koroner Arter Bypass Cerrahisinde Fosforilkolin Kaplı Devrelerin Nötrofil Jelatinaz İlişkili Lipokalin Seviyelerine Etkisi

Aim: Predicting the effects of Phosphorylcholine (PC)-coated cardiopulmonary bypass (CPB) circuits particularlyon renal function by conventional serum biomarkers such as creatinine is not feasible. We compared the effects ofnon-coated and modern PC-coated CPB circuits on inflammatory response and particularly on renal function bymeasuring serum Neutrophil gelatinase-associated lipocalin (NGAL) in patients scheduled for elective coronaryartery bypass graft (CABG) surgery. Material And Methods: Thirty-two consecutive patients undergoing first-time elective coronary artery bypass graft- ing were randomly assigned to PC-coated (PC, n = 17) and noncoated (control, n = 15) circuit groups.Results: No significant differences in pre- or post-operative red blood cell (RBC), white blood cell (WBC), platelet(PLT) counts, creatinine, blood urea nitrogen (BUN) and C-reactive protein (CRP) values were noted. There were nosignificant difference of cytokine levels at any time points in both groups. Pre-operative NGAL levels are similar inboth groups. There was a marked increase in plasma NGAL levels during per-operative period in both groups whichwas not significant. Raise of plasma NGAL level was significantly higher in the control group (PC: 264 ± 105 ng/dlvs. 416 ± 174 ng/dl, p=0.004). Plasma NGAL levels began to decline through post-operative 6th with a statisticallysignificant difference between the groups (PC: 183.1 ± 123 ng/dl vs. 265.2 ± 144 ng/dl, p=0.028). NGAL levels dur- ing post-operative 1st week were similar in both groups.Conclusions: In this study, we observed low levels of NGAL with PC-coating which might be associated with im- proved renal function that could not be predicted with conventional serum biomarkers.

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