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Procalcitonin Dynamics After Long-Term Ventricular Assist Device Implantation

J. Kettner, M. Holek, J. Franekova, A. Jabor, M. Pindak, H. Riha, J. Kautzner, J. Pirk,

. 2017 ; 26 (6) : 599-603. [pub] 20161116

Language English Country Australia

Document type Journal Article, Observational Study

Persistent link   https://www.medvik.cz/link/bmc18010845

BACKGROUND: Infectious complications (IC) are one of the main causes of worsening prognosis after long-term ventricular assist device (LVAD) implantation. Procalcitonin (PCT) is widely used for diagnosis of a bacterial infection. The objective of this study was to assess PCT dynamics after LVAD surgery and their relationship to the infectious complications. METHODS: A total of 25 consecutive patients indicated for LVAD implantation as a bridge to heart transplant were included. Procalcitonin levels were prospectively assessed before surgery and during the postoperative period (day 1, 2, 14 and 30). Values were compared according to the presence of IC. RESULTS: Procalcitonin levels were low before surgery, raised significantly within 1st and 2nd day after operation and decreased in the 14th and 30th days back to the baseline. There was no significant difference in PCT values between patients with or without IC as well as with or without right ventricle assist device (RVAD). Acute renal failure (ARF) increased PCT significantly only 14 days after LVAD implantation. In patients with ARF and/or RVAD we observed significantly higher PCT values in the 2nd, 14thand 30thday after operation. In subjects with IC and/or ARF and/or RVAD we also observed significantly elevated PCT concentrations 2 and 14 days after surgery. CONCLUSIONS: Our data show that the ability of PCT to detect IC in patients after LVAD implantation is limited and its concentrations more likely correlate with postoperative complications in general.

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$a BACKGROUND: Infectious complications (IC) are one of the main causes of worsening prognosis after long-term ventricular assist device (LVAD) implantation. Procalcitonin (PCT) is widely used for diagnosis of a bacterial infection. The objective of this study was to assess PCT dynamics after LVAD surgery and their relationship to the infectious complications. METHODS: A total of 25 consecutive patients indicated for LVAD implantation as a bridge to heart transplant were included. Procalcitonin levels were prospectively assessed before surgery and during the postoperative period (day 1, 2, 14 and 30). Values were compared according to the presence of IC. RESULTS: Procalcitonin levels were low before surgery, raised significantly within 1st and 2nd day after operation and decreased in the 14th and 30th days back to the baseline. There was no significant difference in PCT values between patients with or without IC as well as with or without right ventricle assist device (RVAD). Acute renal failure (ARF) increased PCT significantly only 14 days after LVAD implantation. In patients with ARF and/or RVAD we observed significantly higher PCT values in the 2nd, 14thand 30thday after operation. In subjects with IC and/or ARF and/or RVAD we also observed significantly elevated PCT concentrations 2 and 14 days after surgery. CONCLUSIONS: Our data show that the ability of PCT to detect IC in patients after LVAD implantation is limited and its concentrations more likely correlate with postoperative complications in general.
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$a Holek, Martin $u Department of Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic; 3(rd) Faculty of Medicine, Charles University in Prague, 3 Prague, Czech Republic. Electronic address: martin.holek@ikem.cz.
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$a Franekova, Janka $u Department of Laboratory Methods, Institute for Clinical and Experimental Medicine, Prague, Czech Republic; 3(rd) Faculty of Medicine, Charles University in Prague, 3 Prague, Czech Republic.
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$a Jabor, Antonin $u Department of Laboratory Methods, Institute for Clinical and Experimental Medicine, Prague, Czech Republic; 3(rd) Faculty of Medicine, Charles University in Prague, 3 Prague, Czech Republic.
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$a Pindak, Marian $u Department of Anesthesiology and Intensive Care Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
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$a Riha, Hynek $u Department of Anesthesiology and Intensive Care Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
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$a Kautzner, Josef $u Department of Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
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$a Pirk, Jan $u Department of Cardiovascular Surgery, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
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