Association between intraoperative ventilator settings and plasma levels of soluble receptor for advanced glycation end-products in patients without pre-existing lung injury
Corresponding Author
Matthieu Jabaudon
Department of Anesthesiology, Critical Care and Perioperative Medicine, Estaing Hospital, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
EA 7281, R2D2, Clermont University, University of Auvergne, Clermont-Ferrand, France
Correspondence: Matthieu Jabaudon, Department of Anesthesiology, Critical Care and Perioperative Medicine, Intensive Care Unit, Estaing University Hospital, Clermont Université, Université D'Auvergne, EA 7281, R2D2, CHU Clermont-Ferrand, 1 Place Lucie Aubrac, 63003 Clermont Ferrand Cedex 1, France. Email: [email protected]Search for more papers by this authorEmmanuel Futier
Department of Anesthesiology, Critical Care and Perioperative Medicine, Estaing Hospital, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
EA 7281, R2D2, Clermont University, University of Auvergne, Clermont-Ferrand, France
Search for more papers by this authorLaurence Roszyk
EA 7281, R2D2, Clermont University, University of Auvergne, Clermont-Ferrand, France
Department of Medical Biochemistry and Molecular Biology, Estaing University Hospital, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
Search for more papers by this authorVincent Sapin
EA 7281, R2D2, Clermont University, University of Auvergne, Clermont-Ferrand, France
Department of Medical Biochemistry and Molecular Biology, Estaing University Hospital, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
Search for more papers by this authorBruno Pereira
Department of Clinical Research and Innovation (DRCI), Clermont-Ferrand University Hospital, Clermont-Ferrand, France
Search for more papers by this authorJean-Michel Constantin
Department of Anesthesiology, Critical Care and Perioperative Medicine, Estaing Hospital, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
EA 7281, R2D2, Clermont University, University of Auvergne, Clermont-Ferrand, France
Search for more papers by this authorCorresponding Author
Matthieu Jabaudon
Department of Anesthesiology, Critical Care and Perioperative Medicine, Estaing Hospital, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
EA 7281, R2D2, Clermont University, University of Auvergne, Clermont-Ferrand, France
Correspondence: Matthieu Jabaudon, Department of Anesthesiology, Critical Care and Perioperative Medicine, Intensive Care Unit, Estaing University Hospital, Clermont Université, Université D'Auvergne, EA 7281, R2D2, CHU Clermont-Ferrand, 1 Place Lucie Aubrac, 63003 Clermont Ferrand Cedex 1, France. Email: [email protected]Search for more papers by this authorEmmanuel Futier
Department of Anesthesiology, Critical Care and Perioperative Medicine, Estaing Hospital, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
EA 7281, R2D2, Clermont University, University of Auvergne, Clermont-Ferrand, France
Search for more papers by this authorLaurence Roszyk
EA 7281, R2D2, Clermont University, University of Auvergne, Clermont-Ferrand, France
Department of Medical Biochemistry and Molecular Biology, Estaing University Hospital, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
Search for more papers by this authorVincent Sapin
EA 7281, R2D2, Clermont University, University of Auvergne, Clermont-Ferrand, France
Department of Medical Biochemistry and Molecular Biology, Estaing University Hospital, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
Search for more papers by this authorBruno Pereira
Department of Clinical Research and Innovation (DRCI), Clermont-Ferrand University Hospital, Clermont-Ferrand, France
Search for more papers by this authorJean-Michel Constantin
Department of Anesthesiology, Critical Care and Perioperative Medicine, Estaing Hospital, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
EA 7281, R2D2, Clermont University, University of Auvergne, Clermont-Ferrand, France
Search for more papers by this authorAbstract
Background and objective
The soluble form of the receptor for advanced glycation end-products (sRAGE) is elevated and correlated with severity in patients with acute respiratory distress syndrome (ARDS). The impact of ventilator settings on plasma levels of sRAGE, in patients with or without pre-existing lung injury, remains under-investigated to date. Our objective was to assess the effects of a lung-protective ventilation strategy (combining low tidal volume, positive end-expiratory pressure and recruitment maneuvers), as compared with a non-protective approach (with high tidal volume and zero end-expiratory pressure), on plasma levels of sRAGE in patients without lung injury undergoing major abdominal surgery.
Methods
Plasma samples were obtained from 95 patients enrolled in a large randomized controlled trial of lung-protective ventilation for major abdominal surgery. Plasma levels of sRAGE were measured in duplicate with an enzyme-linked immunoassay on day 1, immediately after surgery, and on postoperative days 1, 3 and 7.
Results
Early postoperative plasma levels of sRAGE were significantly lower in the lung-protective ventilation group (n = 47) than in the non-protective ventilation group (n = 48) (mean (standard deviation), 1782 (836) vs 2171 (1678) pg/mL, respectively, P = 0.03). Intraoperative changes in plasma sRAGE were associated with postoperative hypoxemia and ARDS.
Conclusions
A lung-protective ventilation strategy decreased plasma sRAGE in patients without lung injury undergoing major abdominal surgery compared with the patients with non-protective ventilation. This intraoperative decrease could reflect a lesser degree of epithelial injury.
Supporting Information
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| resp12583-sup-0001-si.docx18.7 KB |
Table S1 Intraoperative changes in plasma levels of sRAGE (the difference in plasma sRAGE (pg/mL) as measured before and immediately after surgery) and their correlation with postoperative outcomes in patients from both groups. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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