Immunity and Its Effect on the Incidence of Multiple Organ Failure in Patients after the Heart Surgery

• Main Authors: E. A. Partylova, Yu. I. Petrishchev, I. V. Kudryavtsev, O. G. Malkova, A. L. Levit
• Format: Article
• Language: Russian
• Published: Russian Academy of Medical Sciences 2019-09-01
• Series: Obŝaâ Reanimatologiâ
• Subjects: monocytes; components of the complement cascade; phenotype cd14 + hla-dr +; innate immunity; sofa
• Online Access: https://www.reanimatology.com/rmt/article/view/1787

The purpose of the study is to identify the components of immunity, which might predict the development of multiple organ failure in patients after heart surgery.Material and methods. The study included 40 patients who were operated in cardiac surgery Department. The inclusion criteria were the presence of indications for cardiac surgery. The exclusion criteria were the presence of infective endocarditis in patients. Before the operation and after 24 hours we studied the blood level of leukocytes and lymphocytes. We analyzed the phenotype of immune cells using monoclonal antibodies, serum levels of procalcitonin and C3 and C4 complement components. All patients were evaluated for multiple organ disfunction (MOD) using the SOFA scale.The results showed that cardiac surgery leads to the development of MOD, statistically significant multidirectional changes in both quantitative and qualitative composition of all cells of the immune system, significant changes in the level of C3 and C4 components of the cascade of complement and plasma level of pro-calcitonin. ROC analysis was revealed that the relative content of monocytes is less than 7.1% of the number of leukocytes as well as the absolute content of monocytes with the CD14 + HLA-DR + phenotype less than 0.32_109/l in the preoperative period, and the C3 level of the complement component less than 0.52 g/l, as well as the maximum SOFA score in the postoperative period, were the best predictors of MOD after the procedures.Conclusion. The components of innate immunity make it possible to predict the complication of the cardiac surgery, earlier than the SOFA scale.