Journal
SCANDINAVIAN JOURNAL OF CLINICAL & LABORATORY INVESTIGATION
Volume 80, Issue 8, Pages 640-643Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1080/00365513.2020.1824297
Keywords
Hypothermic circulatory arrest; aortic surgery; biomarkers; critical illness; hCG beta; SPINK1; trypsin; trypsinogen
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Funding
- University of Helsinki
- Helsinki University Hospital Special Funds
- Finnish Funding Agency for Technology and Innovation (TEKES)
- Finnish Cancer Foundation
- Academy of Finland
- Finnish Society of Clinical Chemistry
- Sigrid Juselius Foundation
- Laboratoriolaaketieteen edistamissaatio
- Finska Lakaresallskapet
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The concentrations of several diagnostic markers have been found to increase dramatically in critically ill patients with a severe disturbance of normal physiological homeostasis, without indication of the diseases they are normally associated with. To prevent false diagnoses and inappropriate treatments of critically ill patients, it is important that the markers aiding the selection of second-line treatments are evaluated in such patients and not only in the healthy population and patients with diseases the markers are associated with. The levels of trypsinogen isoenzymes, the trypsin inhibitor serine peptidase inhibitor Kazal type 1 (SPINK1), hCG and hCG beta, which are used as pancreatitis and cancer markers, were analyzed by immunoassays from serum samples of 17 adult patients who have undergone surgery of the ascending aorta during hypothermic circulatory arrest (HCA) with optional selective cerebral perfusion. Highly elevated levels of trypsinogen-1, -2 and -3, SPINK1 and hCG beta were observed in patients after HCA. This was accompanied by increased concentrations of S100 beta and NSE. In conclusion, this study highlights the importance of critically evaluating the markers used for aiding selection of second line of treatments in critically ill patients.
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