Abstract

Aim: The release of procalcitonin (PCT) has been suggested to be related to the type of surgery and cardiopulmonary bypass (CPB). We aimed to investigate the associations of PCT with hemodynamic stability, type of cardiac surgery, and complications.

Methods: Our study was conducted in 2015 on 76 adult patients divided into three groups according to types of surgery: group I consisted of coronary artery bypass grafting with CPB, group II consisted of cardiac valve replacement, and group III included left ventricle assist device implantation. The patients’ serum PCT values were measured preoperatively before induction, 24 and 48 hours postoperatively, and when a complication occurred.

Results: Preoperative PCT levels of the groups were similar. The PCT level in group I was lowest preoperatively, highest in postoperative 24 hours, and showed a decline postoperatively from 24 hours to 48 hours. In group II, the PCT level was increased in postoperative 24 and 48 hours compared to the preoperative level, and there was no difference between postoperative 24- and 48-hour values. In group III, the PCT level was lowest preoperatively and highest in postoperative 24 hours, while the postoperative 48-hour value was lower than the 24-hour value. Intensive care unit (ICU) stay with a higher P1PCTlevel correlated with longer ICU stay. There were no differences between patients with PCT levels ≥ 0.5 and <0.5 regarding the duration of postoperative mechanical ventilation (MV), inotropic agents, and hospitalization. Patients with higher P2PCThad a longer duration of ICU stay, postoperative MV, and hospitalization. There was a correlation between the P2PCT level and the risk of complications.

Conclusion: Increased postoperative PCT levels were associated with complications, longer durations of of hospitalization, ICU stay, and postoperative MV. We suggest that PCT might be a marker for early diagnosis of complications and follow-up of the clinical course.

Keywords: Open-heart surgery, procalcitonin, mortality, left ventricular assist device

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