# Markers of inflammation and immunological competence: Assessment in the early postoperative phase of cardiac surgery involving extracorporeal circulation

## TL;DR

This study examines how inflammation and immune markers change after heart surgery using a heart-lung machine, showing significant postoperative changes that could help guide patient care.

## Contribution

The study provides new insights into the dynamics of specific immune markers in the early postoperative phase of cardiac surgery involving extracorporeal circulation.

## Key findings

- CRP and SAA levels, along with CD14 and pro-inflammatory monocyte proportions, significantly increased postoperatively.
- HLA-DR CD14 monocyte proportions significantly decreased after surgery.
- No significant age-related differences were observed in the studied immune markers.

## Abstract

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 T CD14 T in patients who underwent heart surgery using extracorporeal circulation (on-pump).

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.

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).

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.