Abstract
Background: To gain insight into the role and relevance of inflammatory and immunological markers in the comprehensive assessment of a patient’s immune response to surgical procedures. This study focused on investigating preoperative and postoperative serum levels dynamics of SAA, CRP, and proportion of HLA-DR+CD14+monocytes, CD14+ monocytes, and pro-inflammatory monocytes CD16+CD14+ in patients who underwent heart surgery using extracorporeal circulation (on-pump).
Methods: An observational, prospective study was conducted at the Heart Center of the Clinical Center of the University of Sarajevo on 53 patients divided into 3 age groups: 50 – 59, 60 – 69, and 70 – 80. The serum levels of CRP and SAA were quantitatively determined by immunonephelometry. At the same time, flow cytometry technology was applied to measure the proportion of CD14+ monocytes, HLA-DR+CD14+monocytes, and pro-inflammatory CD16+CD14+ monocytes.
Results: Measured values of CRP, SAA, proportion of monocytes CD14+, and proportion of pro-inflammatory monocytes CD16+CD14+ are significantly increased postoperatively compared to the preoperative values (p<0.05). The proportion of HLA-DR+CD14+ monocytes is lower postoperatively compared to preoperative values (p<0.001). Furthermore, there are no significant gender differences in the preoperative or postoperative parameters (p>0.05), with the notable exception of the preoperative proportion of CD14+monocytes (p<0.05). The analysis of age-related differences indicates no significant changes in the observed preoperative and postoperative parameters among the defined age groups (p>0.05).
Conclusion: Early monitoring of inflammatory and immunological markers in the postoperative phase could be valuable for healthcare professionals to implement prompt interventions to mitigate negative outcomes.
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