Effect of cardiopulmonary bypass on activated partial thromboplastin time waveform analysis, serum procalcitonin and C-reactive protein concentrations

摘要: Systemic inflammatory response syndrome (SIRS) is a frequent condition after cardiopulmonary bypass (CPB) and makes conventional biological tests fail to detect postoperative sepsis. Biphasic waveform (BPW) analysis new test derived from activated partial thromboplastin time that has recently been proposed for sepsis diagnosis. The aim of this study was investigate the accuracy BPW cardiac surgery under CPB. We conducted prospective in American Society Anesthesiologists' (ASA) physical status III IV patients referred Procalcitonin (PCT) were recorded before every day during first week following surgery. Patients then divided into three groups: presenting no SIRS, with non-septic SIRS Thirty two included. occurred 16 (50%) including 5 (16%) 11 (34%) SIRS. PCT significantly increased compared (0.9 [0.5-2.2] vs. 8.1 [2.0-21.3] ng/l 0.10 [0.09-0.14] 0.29 [0.16-0.56] %T/s BPW; P < 0.05 both). observed difference peak value between group (8.4 [7.5-32.2] 7.8 [1.9-17.5] ng/l; = 0.67). On other hand, we found higher (0.57 [0.54-0.78] 0.19 [0.14-0.29] %T/s; 0.01). threshold 0.465%T/s able discriminate groups sensitivity 100% specificity 93% (area curve: 0.948 +/- 0.039; Applying previously published 0.25%T/s, 72% these groups. Neither C-reactive protein (CRP) nor had significant predictive curve CRP 0.659 0.142; 0.26 area 0.704 0.133; 0.15). potential clinical applications diagnosis period