Accuracy of serum surfactant protein concentration in predicting PPCs in patients at moderate risk for PPCs undergoing abdominal surgery / 中华麻醉学杂志

ABSTRACT

Objective:To evaluate the accuracy of serum surfactant protein concentration in predicting postoperative pulmonary complications (PPCs) in the patients at moderate risk for PPCs undergoing abdominal surgery.Methods:Fifty-eight patients of both sexes, with the predicted ARISCAT score of 26-44 points, scheduled for elective abdominal gastrointestinal surgery, were studied.Central venous blood samples were collected before operation (T 0), at 30 min after extubation (T 1) and at 1 day after surgery (T 2) for determination of serum surfactant protein A (SP-A) and surfactant protein B (SP-B) in serum by enzyme-linked immunosorbent assay.The occurrence of PPCs during the postoperative hospitalization was recorded.The patients were divided into PPCs group and non-PPCs group according to whether PPCs occurred. The receiver operating characteristic curve was used to analyze the accuracy of serum SP-A and SP-B concentrations in predicting PPCs. Results:Compared with the baseline value at T 0, the serum SP-B concentrations were significantly increased at T 1 in group PPCs, and the concentrations of serum SP-A and SP-B were significantly decreased at T 2 in both groups ( P<0.05). The concentrations of serum SP-A and SP-B were significantly decreased at T 2 than at T 1 in both groups ( P<0.05). Compared with non-PPCs group, the serum concentrations of SP-A at T 0 and SP-B at T 1 were significantly increased in group PPCs ( P<0.05). The area under the receiver operating characteristic curve of serum SP-B concentrations in predicting PPCs at T 1 was 0.908 (95% confidence interval 0.821-0.996), and the cut-off value was 26.3 ng/ml, sensitivity 0.90, and specificity 0.81. Conclusion:The accuracy of serum SP-B concentrations measured at 30 min after extubation in predicting PPCs is higher in the patients at moderate risk for PPCs undergoing abdominal surgery.