Accuracy of IL-6 and IL-8 concentrations in exhaled breath condensate in predicting postoperative ARDS in patients undergoing cardiac surgery under cardiopulmonary bypass
10.3760/cma.j.issn.0254-1416.2019.07.004
- VernacularTitle:呼出气冷凝液IL-6和IL-8浓度预测CPB心脏手术患者术后ARDS的准确性
- Author:
Lulin ZHAO
1
;
Lei YAO
;
Boxiang DU
;
Jie SONG
Author Information
1. 南通市第一人民医院麻醉科 226001
- Keywords:
Interleukins;
Respiratory distress syndrome,adult;
Cardiopulmonary bypass;
Heart valve prosthesis implantation;
Exhaled breath condensate
- From:
Chinese Journal of Anesthesiology
2019;39(7):780-784
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the accuracy of interleukin-6 (IL-6) and IL-8 concentrations in exhaled breath condensate (EBC) in predicting postoperative acute respiratory distress syndrome (ARDS) in the patients undergoing cardiac surgery under cardiopulmonary bypass (CPB).Methods Forty-two American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients of both sexes,aged 18-64 yr,scheduled for elective cardiac valve replacement under CPB,were selected.EBC samples were collected for determination of the concentrations of IL-6 and IL-8 by enzyme-linked immunosorbent assay.The patients were divided into either ARDS group or non-ARDS group according to whether the patients developed ARDS after surgery.The receiver operating characteristic curve for IL-6 and IL-8 concentrations in EBC in diagnosing postoperative ARDS was plotted,and the area under the curve and 95% confidence interval (CI) were calculated.The critical value,sensitivity and specificity were calculated according to the corresponding concentrations of IL-6 and IL-8 in EBC when Youden index reached the maximal value.Results Twenty-two patients developed postoperative ARDS,and the incidence was 52%.The concentrations of IL-6 and IL-8 in EBC were significantly higher at T2-4 than at T1 in two groups (P<0.05).Compared with group nonARDS,the concentrations of IL-6 and IL-8 in EBC were significantly increased at T2-4 in group ARDS (P<0.05).The area under the curve (95% CI) of IL-6 concentrations in EBC measured at T2-4 in predicting postoperative ARDS was 0.822 (0.673-0.922),0.850 (0.706-0.941) and 0.906 (0.775-0.974),respectively,the critical value was 2.92,5.04 and 2.64 pg/ml,respectively,the sensitivity was 95.5%,68.2% and 77.3%,respectively,and the specificity was 70.0%,90.0% and 90.0%,respectively.The area under the curve (95% CI) of IL-8 concentrations in EBC measured at Y24 in predicting postoperative ARDS was 0.700 (0.539-0.831),0.851 (0.707-0.942) and 0.737 (0.579-0.861),respectively,the critical value was 26.75,42.73 and 21.86 pg/ml,respectively,the sensitivity was 68.2%,77.3% and 72.7%,respectively,and the specificity was 65.0%,80.0% and 70.0%,respectively.Conclusion The concentrations of IL-6 and IL-8 in EBC can accurately predict the occurrence of postoperative ARDS in the patients undergoing cardiac surgery under CPB.