Serum Free Fatty Acid Concentration Predicts ARDS after Off-Pump CABG: A Prospective Observational Study.

IF 4.6 2区医学 Q1 RESPIRATORY SYSTEM

Lung Pub Date : 2024-10-01 Epub Date: 2024-05-16 DOI:10.1007/s00408-024-00704-3

Peng Lu, Jidan Fan, Xiangyu Li, Zhaoyang Liu, Yuanpu Qi, Zihao Shen, Ziang Wen, Chenlong Yi, Meijuan Song, Xiaowei Wang

{"title":"Serum Free Fatty Acid Concentration Predicts ARDS after Off-Pump CABG: A Prospective Observational Study.","authors":"Peng Lu, Jidan Fan, Xiangyu Li, Zhaoyang Liu, Yuanpu Qi, Zihao Shen, Ziang Wen, Chenlong Yi, Meijuan Song, Xiaowei Wang","doi":"10.1007/s00408-024-00704-3","DOIUrl":null,"url":null,"abstract":"Background: Free fatty acids (FFAs) are established risk factors for various cardiovascular and metabolic disorders. Elevated FFAs can trigger inflammatory response, which may be associated with the occurrence of acute respiratory distress syndrome (ARDS) in cardiac surgery. In this prospective study, we aimed to investigate the association between circulating FFA and the incidence of ARDS, as well as the length of ICU stay, in patients undergoing off-pump coronary artery bypass grafting (CABG).Methods: We conducted a single-center, prospective, observational study among patients undergoing off-pump CABG. The primary endpoint was the occurrence of ARDS within 6 days after off-pump CABG. Serum FFA were measured at baseline and 24 h post-procedure, and the difference (Δ-FFA) was calculated.Results: A total of 180 patients were included in the primary analysis. The median FFA was 2.3 mmol/L (quartile 1 [Q1]-Q3, 1.4-3.2) at baseline and 1.5 mmol/L (Q1-Q3, 0.9-2.3) 24 h after CABG, with a Δ-FFA of 0.6 mmol/L (Q1-Q3, -0.1 to 1.6). Patients with elevated Δ-FFA levels had a significantly higher ARDS occurrence (55.6% vs. 22.2%; P < 0.001). Elevated Δ-FFA after off-pump CABG correlated with a significantly lower PaO2/FiO2 ratio, prolonged mechanical ventilation, and extended length of ICU stay. The area under the curve (AUC) of Δ-FFA for predicting ARDS (AUC, 0.758; 95% confidence interval, 0.686-0.831) significantly exceeded the AUC of postoperative FFA (AUC, 0.708; 95% CI 0.628-0.788; P < 0.001).Conclusions: Elevated Δ-FFA levels correlated with ARDS following off-pump CABG. Monitoring FFA may assist in identifying high-risk patients for ARDS, facilitating timely interventions to improve clinical outcomes.","PeriodicalId":18163,"journal":{"name":"Lung","volume":" ","pages":"523-532"},"PeriodicalIF":4.6000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Lung","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00408-024-00704-3","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/5/16 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Free fatty acids (FFAs) are established risk factors for various cardiovascular and metabolic disorders. Elevated FFAs can trigger inflammatory response, which may be associated with the occurrence of acute respiratory distress syndrome (ARDS) in cardiac surgery. In this prospective study, we aimed to investigate the association between circulating FFA and the incidence of ARDS, as well as the length of ICU stay, in patients undergoing off-pump coronary artery bypass grafting (CABG).

Methods: We conducted a single-center, prospective, observational study among patients undergoing off-pump CABG. The primary endpoint was the occurrence of ARDS within 6 days after off-pump CABG. Serum FFA were measured at baseline and 24 h post-procedure, and the difference (Δ-FFA) was calculated.

Results: A total of 180 patients were included in the primary analysis. The median FFA was 2.3 mmol/L (quartile 1 [Q1]-Q3, 1.4-3.2) at baseline and 1.5 mmol/L (Q1-Q3, 0.9-2.3) 24 h after CABG, with a Δ-FFA of 0.6 mmol/L (Q1-Q3, -0.1 to 1.6). Patients with elevated Δ-FFA levels had a significantly higher ARDS occurrence (55.6% vs. 22.2%; P < 0.001). Elevated Δ-FFA after off-pump CABG correlated with a significantly lower PaO₂/FiO₂ ratio, prolonged mechanical ventilation, and extended length of ICU stay. The area under the curve (AUC) of Δ-FFA for predicting ARDS (AUC, 0.758; 95% confidence interval, 0.686-0.831) significantly exceeded the AUC of postoperative FFA (AUC, 0.708; 95% CI 0.628-0.788; P < 0.001).

Conclusions: Elevated Δ-FFA levels correlated with ARDS following off-pump CABG. Monitoring FFA may assist in identifying high-risk patients for ARDS, facilitating timely interventions to improve clinical outcomes.

Abstract Image

查看原文本刊更多论文

血清游离脂肪酸浓度可预测非抽吸式 CABG 术后的 ARDS：一项前瞻性观察研究。

背景：游离脂肪酸（FFAs）是导致各种心血管疾病和代谢紊乱的既定风险因素。游离脂肪酸升高可引发炎症反应，这可能与心脏手术中急性呼吸窘迫综合征（ARDS）的发生有关。在这项前瞻性研究中，我们旨在调查循环中的 FFA 与接受非泵式冠状动脉旁路移植术（CABG）患者的 ARDS 发生率以及重症监护室住院时间之间的关系：我们在接受体外循环冠状动脉旁路移植术的患者中开展了一项单中心、前瞻性、观察性研究。研究的主要终点是非体外循环冠状动脉旁路移植术后 6 天内发生 ARDS。在基线和手术后 24 小时测量血清 FFA，并计算差异（Δ-FFA）：结果：共有 180 名患者被纳入主要分析。基线时FFA的中位数为2.3 mmol/L（四分位数1 [Q1]-Q3，1.4-3.2），CABG术后24小时为1.5 mmol/L（Q1-Q3，0.9-2.3），Δ-FFA为0.6 mmol/L（Q1-Q3，-0.1-1.6）。Δ-FFA水平升高的患者发生ARDS的比例明显更高（55.6%对22.2%；P 2/FiO2比值），机械通气时间更长，重症监护室的住院时间也更长。Δ-FFA预测ARDS的曲线下面积（AUC）（AUC，0.758；95% 置信区间，0.686-0.831）明显超过术后FFA的AUC（AUC，0.708；95% CI 0.628-0.788；P 结论：Δ-FFA水平升高与体外循环冠状动脉置换术后的ARDS相关。监测 FFA 可能有助于识别 ARDS 的高危患者，促进及时干预以改善临床预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Lung 医学-呼吸系统

CiteScore

9.10

自引率

10.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Lung publishes original articles, reviews and editorials on all aspects of the healthy and diseased lungs, of the airways, and of breathing. Epidemiological, clinical, pathophysiological, biochemical, and pharmacological studies fall within the scope of the journal. Case reports, short communications and technical notes can be accepted if they are of particular interest.