SATS 2009 Final Program - Scandinavian Association for Thoracic ...

S10:3
VALIDATION OF CYSTATIN C WITH IOHEXOL CLEARANCE IN CARDIAC SURGERY.
Brondén Björn 1 , Eyjolfsson Atli 1 , Blomquist Sten 1 , Jönsson Henrik 1
1) Heart and Lung Division, USiL, Sweden
Introduction
Postoperative renal dysfunction after cardiac surgery is not uncommon. Plasma creatinine is the most commonly used
biomarker of glomerular filtration rate (GFR). Serum cystatin C is a more sensitive biomarker of GFR than plasma
creatinine, but has not been validated in cardiac surgery. Iohexol clearance is a reference method for determination
of GFR. The aim of this study is to validate cystatin C with iohexol clearance in cardiac surgery.
Method
Twenty-one patients scheduled for elective coronary artery bypass grafting (CABG) where prospectively enrolled
in the study. Before surgery and on the second postoperative day an iohexol clearance was performed. Cystatin
C, creatinine, creatinine clearance and C-reactive protein (CRP) were determined before surgery and on the first,
second, third and fifth postoperative day.
Results
A strong correlation between iohexol clearance and cystatin C was found both pre- and postoperatively (r = -0.80 and
r = -0.89 respectively) and was stronger than the corresponding correlation for creatinine and creatinine clearance.
A significant elevation of cystatin C concentrations was found on the second and third postoperative day, which was
not seen in creatinine concentrations. No correlation was found between CRP, iohexol clearance and cystatin C.
Conclusion
This study validates cystatin C as a marker of glomerular filtration in cardiac surgery. The study did not indicate that
the cystatin C levels were affected as a consequence of the inflammatory response. The study contributes to the
assumption that cystatin C is superior to creatinine in detecting early decline in renal function in cardiac surgery.
S10:4
PLATELET REACTIVITY DURING CARDIOPULMONARY BYPASS (CPB) - CHANGES RELATED TO
POSTOPERATIVE BLEEDING
Ehnsiö Gustaf 1 , Norderfeldt Joakim 1 , Berg Sören 1 , Alfredsson Joakim 1
1) Heart Centre,Linköping, Sweden
Introduction
The use of CPB during CABG surgery is associated with platelet dysfunction and consumption, contributing to
perioperative bleeding. Our aim was to evaluate if platelet activity correlated to blood loss.
Methods
Platelet function in 30 patients undergoing CABG was analyzed using whole blood impedance aggregometry
(Multiplate®) with ADP (adenosin diphosphate), TRAP (thrombin receptor activating peptide), AA (arachidonic
acid) and COL (collagen) as activators. Platelet reactivity and platelet count was analyzed on multiple occasions
perioperatively up to 18h postoperatively.
Results
Platelet reactivity to ADP and TRAP was significantly reduced at 30 minutes of CPB (p