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ORIGINAL ARTICLE   

Chirurgia 2019 April;32(2):59-61

DOI: 10.23736/S0394-9508.18.04797-6

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Dynamics of urine neutrophil gelatinase-associated lipocalin in cardiac surgery patients in the near term after surgery

Inkar Y. SAGATOV , Ulugbek S. MEDEUBEKOV

Department of Cardiac Surgery, A.N. Syzganov National Scientific Center of Surgery, Almaty, Kazakhstan



BACKGROUND: Acute renal injury (ARI) is a spread complication after heart operation. Numerous investigations have shown that urine neutrophil gelatinase-associated lipocalin (u-NGAL) allows to predict the development of ARI in early postoperative period versus the indicators serum creatinine. Unfortunately, u-NGAL is not widely used yet in clinical practice of cardiosurgical hospital.
METHODS: This article shows the dynamics of kidney markers in patients who underwent surgery with cardiopulmonary bypass, pharmacy-cold (or blood) cardioplegia and hypothermia. For the purpose of comparative evaluation of all 101 patients were divided into 2 groups. Тhe first group was composed of 59 patients (58.4%) with a duration of cardiopulmonary bypass to 150 min, while the second group was composed by 42 patients (41.6%) with a duration of more than 150 min cardiopulmonary bypass.
RESULTS: The results established that the mean indicators of u-NGAL right after operation in patients of the first group made 475.2±914.0 (0.0-3568.0) ng/mL, and in patients of the second group 1106.9±1588.3 (10.3-5520.0) ng/mL. The mean indicators of u-NGAL in 2 hours after operation in patients of the first group made 317.5±579.2 (0.0-1645.0) ng/mL, and in patients of the second group 541.6±717.7 (9.5-2434.0) ng/mL. The received data indicate that after heart operation on pump the level of u-NGAL increased significantly without delay in both groups. At the same time the patients of the second group had comparatively high rise of u-NGAL both right after operation and in 2 and 6 hours after its ending. At the same time the indicators of serum creatinine and serum urea were not practically changed right after operation and in 2 and 6 hours after its ending in patients with duration of bypass time less than 150 minutes, leaving in the range of norm. But in patients of the second group that had a bypass time more than 150 minutes, the indicators of the serum creatinine and serum urea after 2 hours monitoring had a little tendency to grow, but at the same time, nevertheless, leaving in the range of normal indices.
CONCLUSIONS: It turned out that patients undergoing cardiac surgery, which made surgery a lasting cardiopulmonary bypass more than 150 min performance u-NGAL, some immediately after the operation and 2 hours after the operation, is relatively higher than those in patients with a duration of less than 150 min cardiopulmonary bypass.


KEY WORDS: Neutrophil gelatinase-associated lipocalin protein - Lipocalins - Urea - Creatinine - Cardiopulmonary bypass

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