Yael Lichter, Amir Gal Oz, Uri Carmi, Nimrod Adi, Asaph Nini, Yoel Angel, Andrey Nevo, Daniel Aviram, Itay Moshkovits, Noam Goder, Dekel Stavi
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We compared CRP levels during the first 5 days of ECMO operation, between different groups of patients according to ECMO configurations, Coronavirus disease 2019 (COVID-19) status, and mechanical ventilation parameters.</p><p><strong>Results: </strong>There was a statistically significant decrease in CRP levels during the first 5 days of veno-venous (VV) ECMO (173 ± 111 mg/L, 154 ± 107 mg/L, 127 ± 97 mg/L, 114 ± 100 mg/L and 118 ± 90 mg/L for days 1-5 respectively, <i>p</i> < 0.001). Simultaneously, there was a significant reduction in ventilatory parameters, as represented by the mechanical power (MP) calculation, from 24.02 ± 14.53 J/min to 6.18 ± 4.22 J/min within 3 h of VV ECMO initiation (<i>p</i> < 0.001). There was non-significant trend of increase in CRP level during the first 5 days of veno arterial (VA) ECMO (123 ± 80 mg/L, 179 ± 91 mg/L, 203 ± 90 mg/L, 179 ± 95 mg/L and 198 ± 93 for days 1-5 respectively, <i>p</i> = 0.126) and no significant change in calculated MP (from 14.28 ± 8.56 J/min to 10.81 ± 8.09 J/min within 3 h if ECMO initiation, <i>p</i> = 0.071).</p><p><strong>Conclusions: </strong>We observed a significant decrease in CRP levels during the first 5 days of VV ECMO support, and suggest that the concomitant reduction in ventilatory MP may have mitigated the degree of alveolar stress and strain that could have contributed to a decrease in the systemic inflammatory process.</p>","PeriodicalId":1,"journal":{"name":"Accounts of Chemical Research","volume":null,"pages":null},"PeriodicalIF":16.4000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10787388/pdf/","citationCount":"0","resultStr":"{\"title\":\"Kinetics of C-reactive protein during extracorporeal membrane oxygenation.\",\"authors\":\"Yael Lichter, Amir Gal Oz, Uri Carmi, Nimrod Adi, Asaph Nini, Yoel Angel, Andrey Nevo, Daniel Aviram, Itay Moshkovits, Noam Goder, Dekel Stavi\",\"doi\":\"10.1177/03913988231213511\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The exposure of blood to the artificial circuit during extracorporeal membrane oxygenation (ECMO) can induce an inflammatory response. 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引用次数: 0
摘要
背景:体外膜氧合(ECMO)过程中,血液暴露于人工回路可诱导炎症反应。c反应蛋白(CRP)是一种常用的全身性炎症的生物标志物。方法:在这项回顾性观察性研究中,我们分析了110例经ECMO治疗的危重患者的每日血浆CRP测量结果。我们根据ECMO配置、2019冠状病毒病(COVID-19)状态和机械通气参数,比较不同组患者在ECMO手术前5天的CRP水平。结果:静脉-静脉(VV) ECMO前5天CRP水平下降有统计学意义(1-5天分别为173±111 mg/L、154±107 mg/L、127±97 mg/L、114±100 mg/L和118±90 mg/L, p p p = 0.126),计算MP变化无统计学意义(ECMO启动后3 h内从14.28±8.56 J/min降至10.81±8.09 J/min, p = 0.071)。结论:我们观察到在VV ECMO支持的前5天CRP水平显著下降,并提示伴随的通气MP降低可能减轻了肺泡应激和应变的程度,这可能有助于减少全身炎症过程。
Kinetics of C-reactive protein during extracorporeal membrane oxygenation.
Background: The exposure of blood to the artificial circuit during extracorporeal membrane oxygenation (ECMO) can induce an inflammatory response. C-reactive protein (CRP) is a commonly used biomarker of systemic inflammation.
Methods: In this retrospective observational study, we analyzed results of daily plasma CRP measurements in 110 critically ill patients, treated with ECMO. We compared CRP levels during the first 5 days of ECMO operation, between different groups of patients according to ECMO configurations, Coronavirus disease 2019 (COVID-19) status, and mechanical ventilation parameters.
Results: There was a statistically significant decrease in CRP levels during the first 5 days of veno-venous (VV) ECMO (173 ± 111 mg/L, 154 ± 107 mg/L, 127 ± 97 mg/L, 114 ± 100 mg/L and 118 ± 90 mg/L for days 1-5 respectively, p < 0.001). Simultaneously, there was a significant reduction in ventilatory parameters, as represented by the mechanical power (MP) calculation, from 24.02 ± 14.53 J/min to 6.18 ± 4.22 J/min within 3 h of VV ECMO initiation (p < 0.001). There was non-significant trend of increase in CRP level during the first 5 days of veno arterial (VA) ECMO (123 ± 80 mg/L, 179 ± 91 mg/L, 203 ± 90 mg/L, 179 ± 95 mg/L and 198 ± 93 for days 1-5 respectively, p = 0.126) and no significant change in calculated MP (from 14.28 ± 8.56 J/min to 10.81 ± 8.09 J/min within 3 h if ECMO initiation, p = 0.071).
Conclusions: We observed a significant decrease in CRP levels during the first 5 days of VV ECMO support, and suggest that the concomitant reduction in ventilatory MP may have mitigated the degree of alveolar stress and strain that could have contributed to a decrease in the systemic inflammatory process.
期刊介绍:
Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance.
Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.