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No correlation between serum levels of intercellular adhesion molecules (s-ICAM) and acute renal dysfunction following coronary-artery bypass grafting (CABG)

Introduction

Acute renal dysfunction is a common postoperative complication of CABG. Extracorporeal circulation induces an inflammatory response, causing the release of adhesion molecules by endothelial cells and leukocytes. These adhesion molecules are incriminated in the pathophysiology of renal dysfunction, but their relative importance is unknown. We investigated the relationship between levels of s-ICAM and renal dysfunction following CABG.

Methods and materials

Eighteen consecutive patients undergoing elective, uncomplicated CABG were included. Exclusion criteria were: preoperative creatinine clearance <50 ml/min, age >80 years, hypotension >1 h (MAP <60 mmHg), and congestive heart failure (NYHA III-IV). s-ICAMs were measured by RIA (in ng/ml); (a) 10 min prior to anaesthesia, (b) 2 min after aortic clamp release, (c) at admission to ICU, (d) 4, (e) 8, (f) 12, and (g) 16 h postoperatively, and corrected for haemodilution. Serum creatinine levels (sCr) were measured (a) 10 min prior to anaesthesia, (b) the first, and (c) third postoperative day, and corrected for haemodilution; renal dysfunction was defined as a rise in sCr of >25% over baseline value. Mean levels of s-ICAM of the group of patients with (group I) and without (group III) postoperative renal dysfunction are compared at each time interval. Statistical analysis is performed by Student's t-test.

Results

Postoperative renal dysfunction is observed in eight patients. A comparison of mean s-ICAM (in ng/ml) of both groups is in the Table, differences are not statistically significant.

Conclusion

These results do not support a (major) role for s-ICAM in the pathophysiology of acute renal dysfunction following CABG.

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van Zwienen, J., Voets, A., van Leeuwen, S. et al. No correlation between serum levels of intercellular adhesion molecules (s-ICAM) and acute renal dysfunction following coronary-artery bypass grafting (CABG). Crit Care 3, P088 (2000). https://doi.org/10.1186/cc462

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Keywords

  • Creatinine
  • Congestive Heart Failure
  • Adhesion Molecule
  • Creatinine Clearance
  • Renal Dysfunction