The association of midregional pro-adrenomedullin (MR-proADM) at ICU admission and fluid overload in patients post elective cardiac surgery - Pfortmueller, C. A.; Ott, I.; Muller, M.; Wilson, D.; Schefold, J. C.; Messmer, A. S. (Sci Rep, 2024)
Postoperative fluid overload (FO) after cardiac surgery is common and affects recovery. Predicting FO could help optimize fluid management. This post-hoc analysis of the HERACLES randomized controlled trial evaluated the predictive value of MR-proADM for FO post-cardiac surgery. MR-proADM levels were measured at four different timepoints in 33 patients undergoing elective cardiac surgery. Patients were divided into FO (> 5% weight gain) and no-FO at ICU discharge. The primary outcome was the predictive power of MR-proADM at ICU admission for FO at discharge. Secondary outcomes included the predictive value of MR-proADM for FO on day 6 post-surgery and changes over time. The association between MR-proADM and FO at ICU discharge or day 6 post-surgery was not significant (crude odds ratio (cOR): 4.3 (95% CI 0.5-40.9, p = 0.201) and cOR 1.1 (95% CI 0.04-28.3, p = 0.954)). MR-proADM levels over time did not differ significantly between patients with and without FO at ICU discharge (p = 0.803). MR-proADM at ICU admission was not associated with fluid overload at ICU discharge in patients undergoing elective cardiac surgery. MR-proADM levels over time were not significantly different between groups, although elevated levels were observed in patients with FO.
Keywords: journalArticle; *Adrenomedullin/blood; *Cardiac Surgical Procedures/adverse effects; *Elective Surgical Procedures/adverse effects; *Intensive Care Units; Abbott AG, Anandic Medical Systems, Pan Gas AG Healthcare, Bracco, Hamilton; Abbott Nutrition International, B. Braun Medical AG, CSEM AG, Edwards; Aged; Astellas, Astra Zeneca, CSL Behring, Novartis, Covidien, Phagenesis, Cytel, and; Biomarkers/blood; Cardiac surgery; Clinical Research AG, Nestle, Pierre Fabre Pharma AG, Pfizer, Bard Medica S.A.,; Critical care; Female; Fluid overload; GmbH, Glaxo Smith Kline, Merck Sharp and Dohme AG, Eli Lilly and Company, Baxter,; Humans; Lifesciences Services GmbH, Kenta Biotech Ltd, Maquet Critical Care AB, Omnicare; MR-proADM; Male; Medical AG, Fresenius Kabi, Getinge Group Maquet AG, Drager AG, Teleflex Medical; Middle Aged; Nycomed outside the submitted work. The money was paid into departmental funds; Postoperative Complications/blood/etiology; no personal financial gain applied. All other authors have nothing to disclose