Angiopoietin-2 is associated with capillary leak and predicts complications after cardiac surgery

• DOI: 10.1186/s13613-023-01165-2
• Publication Date: 2023-08-08T10:02:24Z
• Authors: Jakob Wollborn; Zilu Zhang; Julie Gaa; Moritz Gentner; Christian Hausmann; Felix Saenger; Karina Weise; Samuel Justice; Jean-Luca Funk; Hans Felix Staehle; Marie Thomas; Raphael R. Bruno; Babak Saravi; Jan O. Friess; Markus Marx; Hartmut Buerkle; Georg Trummer; Jochen D. Muehlsc...; Daniel Reker; Ulrich Goebel; Felix Ulbrich
• Keywords: Angiopoietin-2; Critical care; RC86-88.9; Research; Endothelial permeability; 610; Capillary leak syndrome; Medical emergencies. Critical care. Intensive care. First aid; Cardiac surgery; 3. Good health; Fluid balance

Patients undergoing cardiac surgery are prone to numerous complications. Increased vascular permeability may be associated with morbidity and mortality due hemodynamic instability, fluid overload, edema formation. We hypothesized that markers of endothelial injury inflammation capillary leak, ultimately increasing the risk postoperative complications.In this prospective, observational, multidisciplinary cohort study at our tertiary academic medical center, we recruited 405 patients. were assessed daily using body impedance electrical analysis, ultrasound, sublingual intravital microscopy, analysis serum biomarkers. Multivariable models, as well machine learning, used association angiopoietin-2 extracellular water common complications after surgery.The majority patients underwent coronary artery bypass grafting, valvular, or aortic surgeries. Across groups, increased postoperatively (20 ± 6 preoperatively 29 7L on day 2; P < 0.001). Concomitantly, levels biomarker rose, showing a strong correlation based time points measurements (r = 0.959, 0.041). Inflammatory (IL-6, IL-8, CRP) biomarkers (VE-Cadherin, syndecan-1, ICAM-1) suggestive leak increased. After controlling for factors formation, found an increase 1 ng/mL in was 0.24L (P Angiopoietin-2 showed odds development acute kidney (OR 1.095 [95% CI 1.032, 1.169]; 0.004) furthermore delayed extubation, longer ICU, higher chance prolonged dependence vasoactive medication. Machine learning predicted when added standard factors.Capillary subsequent formation relevant problems surgery. Levels combination show promising potential predict surgery.German Clinical Trials Registry (DRKS No. 00017057), Date registration 05/04/2019, www.drks.de.