urmjУральский медицинский журналUral Medical Journal2949-4389Ural State Medical University10.52420/umj.23.5.63OGJTOUurmj-1607Research ArticleОригинальные статьи | Original articlesOriginal articlesБиомаркеры как предикторы тяжести полиорганной недостаточности после операций на сердцеBiomarkers as Predictors of Severity Multiple Organ Dysfunctions After Cardiac Surgery (Case Series Study)https://orcid.org/0000-0002-8750-8426ПетрищевЮ. И.PetrishchevYu. I.

Юрий Иванович Петрищев — кандидат медицинских наук, анестезиолог-реаниматолог

Екатеринбург

Yury I. Petrishchev - Candidate of Sciences (Medicine), Anesthesiologist-Resuscitator

Ekaterinburg

jurpetr76@rambler.ruhttps://orcid.org/0000-0002-5305-5449МалковаО. Г.MalkovaO. G.

Ольга Геннадьевна Малкова — доктор медицинских наук, анестезиолог-реаниматолог

Екатеринбург

Olga G. Malkova - Doctor of Sciences (Medicine), Anesthesiologist-Resuscitator

Ekaterinburg

olga.malkova@mail.ruhttps://orcid.org/0000-0002-9112-1259ЛевитА. Л.LevitA. L.

Александр Львович Левит — доктор медицинских наук, заведующий отделением анестезиологи и реанимации; профессор кафедры анестезиологии, реаниматологии, токсикологии; главный внештатный специалист по анестезиологии-реаниматологии; главный внештатный специалист по анестезиологии-реаниматологии по Уральскому федеральному округу

Екатеринбург

Москва

Alexander L. Levit - Doctor of Sciences (Medicine), Head of the Department Anesthesiology & Intensive; Professor of the Department of Anesthesiology, Resuscitation, Transfusiology; Chief Freelance Specialist in Anesthesiology and Resuscitation, Care; Chief Freelance Specialist in Anesthesiology and Resuscitation in the Ural Federal District

Ekaterinburg

Moscow

al_levit@mail.ruСвердловская областная клиническая больница № 1РоссияSverdlovsk Regional Clinical Hospital No. 1Russian FederationСвердловская областная клиническая больница № 1; Уральский государственный медицинский университет; Министерство здравоохранения Свердловской области; Министерство здравоохранения Российской ФедерацииРоссияSverdlovsk Regional Clinical Hospital No. 1; Ural State Medical University; Ministry of Health of the Sverdlovsk Oblast; Ministry of Health of the Russian FederationRussian Federation20241710202423563–76Copyright © Петрищев Ю.И., Малкова О.Г., Левит А.Л., 20242024Петрищев Ю.И., Малкова О.Г., Левит А.Л.Petrishchev Y.I., Malkova O.G., Levit A.L.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.umjusmu.ru/jour/article/view/1607

Введение. Вопрос о возможности предсказания тяжести полиорганной недостаточности, развившейся в послеоперационном периоде у кардиохирургических пациентов, в литературе освещен недостаточно. Многообещающим видится поиск предикторов тяжести полиорганной недостаточности, в т. ч. среди маркеров системной воспалительной реакции.Цель исследования — определить перспективность исследования связи уровня биомаркеров с тяжестью полиорганной недостаточности у пациентов, оперированных на сердце.Материалы и методы. Проведена серия из 7 наблюдений за клиническим течением ближайшего послеоперационного периода у пациентов, которым проведено плановое кардиохирургическое вмешательство. В дооперационном периоде оценивался риск наступления внутригоспитальной летальности с помощью шкалы EuroSCORE II и наличие полиорганной недостаточности с использованием шкалы SOFA. До операции и в начале первых послеоперационных суток исследовался плазменный уровень пресепсина. Также в начале первых послеоперационных суток исследовались плазменные уровни трансфераз и тропинина Т, проводился анализ тяжести полиорганной недостаточности с использованием шкалы SOFA. Оценивалась продолжительность пребывания пациентов в отделении реанимации и интенсивной терапии. Результаты исследования оформлены в виде таблиц и графиков, подвергнуты визуальному анализу.Результаты. Полученные данные не позволяют точно связать уровень маркеров повреждения тканей (аcпартатаминотрансферазы, аланинаминотрансферазы, тропонина Т) и маркера системной воспалительной реакции пресепсина с тяжестью полиорганной недостаточности у пациентов, после операции на сердце. В то же время они не исключают существование такой связи.

Introduction. The question of the possibility of predicting the severity of multiple organ failure that developed in the postoperative period in cardiac surgery patients is not sufficiently covered in the literature.The aim of the study is determine the prospects of studying the relationship between the level of biomarkers and the severity of multiple organ failure in patients undergoing cardiac surgery.Materials and methods. A series of seven observations was carried out on the clinical course of the immediate postoperative period in patients who underwent elective cardiac surgery. In the preoperative period, the risk of in-hospital mortality was assessed using the EuroSCORE II scale and the presence of multiple organ failure using the SOFA scale. Before surgery and at the beginning of the first postoperative day, the plasma level of presepsin was studied. Also, at the beginning of the first postoperative day, plasma levels of transferases and troponia T were studied, and the severity of multiple organ failure was analyzed using the SOFA scale. The length of stay of patients in the ICU was assessed. The results of the study are presented in the form of tables and graphs and subjected to visual analysis.Results. The obtained data do not allow us to accurately link the level of tissue damage markers (aspartate aminotransferase, alanine aminotransferase, troponin T) and the marker of the systemic inflammatory reaction presepsin with the severity of multiple organ failure in patients after cardiac surgery. At the same time, they do not exclude the existence of such a connection.

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The authors declare that there are no conflicts of interest present.