Cholinesterase level is a predictor of systemic inflammatory response syndrome and complications after cardiopulmonary bypass.

Abstract

To study the changes of serum cholinesterase (S-ChE) levels in patients with systemic inflammatory response syndrome (SIRS) after cardiopulmonary bypass (CPB) and its predictive value for multiple organ dysfunction syndrome (MODS). Forty-two patients with SIRS after CPB were selected as the SIRS group. Another 42 patients who did not develop SIRS after CPB were selected as the control group. The S-ChE levels of patients were compared between the two groups at the time of intensive care unit (ICU) admission and 48 hours after admission to the ICU. The correlation between S-ChE levels and Acute Physiology and Chronic Health EvaluationII (APACHEII) score, tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) levels was compared between the two groups at the time of ICU admission and 48 hours after ICU admission, and receiver operator characteristic (ROC) curve analysis was used to analyze the accuracy of S-ChE level in diagnosing MODS in patients with SIRS after CPB. There was no significant difference in the S-ChE levels among the non-SIRS patients between the time of admission to the ICU and 48 hours later. However, the S-ChE levels in SIRS patients exhibited a decreasing trend from 48 hours after ICU admission compared with those at the time of ICU admission. Meanwhile, the S-ChE levels were obviously lower in SIRS patients than in non-SIRS patients at those two time points. Furthermore, we found that S-ChE levels were negatively correlated with APACHEII scores as well as the levels of TNF-α and IL-6 at ICU admission and 48 hours after ICU admission in SIRS patients. Meanwhile, S-ChE levels were associated with the occurrence of MODS of SIRS patients. Subsequent ROC curve analysis revealed that early S-ChE levels could predict the occurrence of SIRS complicated by MODS after CBP. S-ChE was significantly decreased in patients with SIRS after CPB, and the decrease of S-ChE in the early stage was closely related to the severity of SIRS after CBP and the increase of inflammatory cytokines. Meanwhile, there was a close relationship between S-ChE activity and MODS in the early stage.