Abstract | OBJECTIVE: DESIGN: Prospective observational clinical study. SETTING: University hospital cardiothoracic operation theater and intensive care unit. PATIENTS: MEASUREMENTS AND MAIN RESULTS: Whole blood concentrations of selenium, copper, and zinc were measured after induction of anesthesia and 1 hr after admission to the intensive care unit. All patients were separated in a priori defined subgroups according to the development of no organ failure, single organ failure, and ≥ 2 organ failures in the postoperative period. RESULTS: Fifty patients exhibited a significant selenium deficiency already before surgery, whereas copper and zinc concentrations were within the reference range. In all patients, blood levels of selenium, copper, and zinc were significantly reduced after end of surgery when compared to preoperative values ( selenium: 89.05 ± 12.65 to 70.84 ± 10.46 μg/L; zinc: 5.15 ± 0.68 to 4.19 ± 0.73 mg/L; copper: 0.86 ± 0.15 to 0.65 ± 0.14 mg/L; p < .001). During their intensive care unit stay, 17 patients were free from any organ failure, while 31 patients developed single-organ failure and 12 patients multiple organ failure. Multilogistic regression analysis showed that selenium concentrations at end of surgery were independently associated with the postoperative occurrence of multiorgan failure (p = .0026, odds ratio 0.8479, 95% confidence interval 0.7617 to 0.9440). CONCLUSIONS: Cardiac surgery using cardiopulmonary bypass resulted in a profound intraoperative decrease of whole blood levels of antioxidant trace elements. Low selenium concentrations at end of surgery were an independent predictor for the postoperative development of multiorgan failure.
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Authors | Christian Stoppe, Gereon Schälte, Rolf Rossaint, Mark Coburn, Beatrix Graf, Jan Spillner, Gernot Marx, Steffen Rex |
Journal | Critical care medicine
(Crit Care Med)
Vol. 39
Issue 8
Pg. 1879-85
(Aug 2011)
ISSN: 1530-0293 [Electronic] United States |
PMID | 21460705
(Publication Type: Comparative Study, Journal Article)
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Chemical References |
- Biomarkers
- Trace Elements
- Copper
- Selenium
- Zinc
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Biomarkers
(blood)
- Blood Chemical Analysis
- Cardiac Surgical Procedures
(methods, mortality)
- Cardiopulmonary Bypass
(methods, mortality)
- Chi-Square Distribution
- Cohort Studies
- Copper
(blood)
- Female
- Follow-Up Studies
- Hospital Mortality
(trends)
- Hospitals, University
- Humans
- Intensive Care Units
- Linear Models
- Male
- Middle Aged
- Monitoring, Intraoperative
(methods)
- Multiple Organ Failure
(blood, mortality)
- Postoperative Complications
(diagnosis, mortality)
- Prospective Studies
- Selenium
(blood)
- Survival Rate
- Trace Elements
(blood)
- Zinc
(blood)
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