Decrease in serum alkaline phosphatase and prognostic relevance in adult cardiopulmonary bypass

Decrease in serum alkaline phosphatase and prognostic relevance in adult cardiopulmonary bypass

Objective: Cardiopulmonary bypass (CPB) induces an inflammatory response, which can cause loss of alkaline phosphatase (AP) consumed in the process of extracellular nucleotides dephosphorylating disadvantage in this proinflammatory state. It has been reported that the rate of postoperative low AP correlated with increased support needs post surgery and organ dysfunction after pediatric cardiac surgery. However, little is known about the development of perioperative and clinical relevance of depletion AP in adults undergoing CPB.

Methods: A total of 183 patients with left ventricular ejection fraction ≤50% preoperatively underwent mitral valve surgery ± concurrent procedure related in the Department of Cardiac Surgery, Medical University of Vienna, between 2013 and 2016 were included in this retrospective analysis. AP serum measurements at baseline and at days 1-15 post surgery were collected. AP absolute and relative reduction in postoperative day 1 of baseline parameters correlated with perioperative and postoperative early. Receiver operating characteristics used to determine predictors fit and cut-off for postoperative outcome variables.

Results: The operating characteristics Receiver showed a decrease of> 50% of the base AP to predict in-hospital mortality [area under the curve (AUC) 0.807], prolonged intensive care unit stay (> 72 hours, AUC 0.707), mechanical ventilation prolonged (> 24 hours, AUC 0.712) and need for dialysis-related operasi- (AUC 0.736). Patients with perioperative decrease in circulating AP to levels below 50% of the base has significantly decreased survival. Patients with high loss of perioperative AP AP preoperative levels of higher (P <0.001), longer duration of CPB (P <0.001) and a higher incidence of lung artificial support (P <0.001).

Conclusion: Increased perioperative AP loss associated with early adverse outcomes. prospective trial is needed to determine whether this effect can be neutralized by AP perioperative supplementation.

Difference Serum Alkaline Phosphatase Levels in Infants with spontaneous intestinal perforation compared Necrotizing enterocolitis with perforation

Introduction: Data laboratory markers spontaneous intestinal perforation (SIP) and necrotizing enterocolitis (NEC) remains sparse.
Objective: To compare serum levels of alkaline phosphatase in infants with intestinal perforation secondary to SIP vs NEC surgery, and then investigate the possible role of serum alkaline phosphatase to distinguish infants with this condition.

Methods: A retrospective case-control study of infants admitted with bowel perforation from 2005 to 2015. Demographics and Data prenatal, postnatal exposure, and clinical, laboratory, and radiographic findings were drawn from inpatient medical records and analyzed using regression analysis.

p38

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p38

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p38 protein

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Description: N/A

p38 protein

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p38 protein

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E2220879 100ul
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Description: Available in various conjugation types.

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EUR 255
Description: Biotin-Conjugated, FITC-Conjugated , AF350 Conjugated , AF405M-Conjugated ,AF488-Conjugated, AF514-Conjugated ,AF532-Conjugated, AF555-Conjugated ,AF568-Conjugated , HRP-Conjugated, AF405S-Conjugated, AF405L-Conjugated , AF546-Conjugated, AF594-Conjugated , AF610-Conjugated, AF635-Conjugated , AF647-Conjugated , AF680-Conjugated , AF700-Conjugated , AF750-Conjugated , AF790-Conjugated , APC-Conjugated , PE-Conjugated , Cy3-Conjugated , Cy5-Conjugated , Cy5.5-Conjugated , Cy7-Conjugated Antibody

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E2340697 100ul
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Description: Available in various conjugation types.

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Description: Available in various conjugation types.

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E2381051 100ul
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Description: Available in various conjugation types.

p38 Rabbit mAb

E2R25239 100μl
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Description: Available in various conjugation types.

p38 Rabbit mAb

E2R27123 100μl
EUR 225
Description: Available in various conjugation types.

Results: Of the 114 infants included outborn, 48 babies have SIP (cases) and 66 have NEC (control). Upon entry of the hospital refers, serum alkaline phosphatase levels were significantly higher in infants with SIP, ie, the median value of versus236 782 U / L in patients with NEC (p <0.0001), with an adjusted odds ratio (OR) of 4.3 (p <0.05) when the level is> 500 U / L in a multivariate regression model. Infants with gestational age SIP has significantly younger, presented earlier in life, especially with pneumoperitoneum, and have a greater exposure to steroids and indomethacin compared infants with NEC. alkaline phosphatase levels decreased rapidly in infants with the following SIP entry.

Conclusion: A temporary increase in serum alkaline phosphatase levels were independently associated with SIP when compared to the NEC. Studies confirm the role of alkaline phosphatase in the diagnosis of the necessary SIP and has clinical implications and potential prognostic significance.