Maxime Nguyen1, Annabelle Tavernier2, Thomas Gautier3, Serge Aho4, Marie Catherine Morgant5, Belaid Bouhemad6, Pierre-Grégoire Guinot7, Jacques Grober8. 1. Department of Anesthesiology and Intensive Care, Dijon University Hospital, F-21000 Dijon, France; University of Burgundy and Franche-Comté, LNC UMR1231, F-21000 Dijon, France; INSERM, LNC UMR1231, F-21000 Dijon, France; FCS Bourgogne-Franche Comté, LipSTIC LabEx, F-21000 Dijon, France. Electronic address: maxime.nguyen-soenen@chu-dijon.fr. 2. INSERM, LNC UMR1231, F-21000 Dijon, France; FCS Bourgogne-Franche Comté, LipSTIC LabEx, F-21000 Dijon, France; SATT, Grand-Est, SAYENS, France. 3. University of Burgundy and Franche-Comté, LNC UMR1231, F-21000 Dijon, France; INSERM, LNC UMR1231, F-21000 Dijon, France; FCS Bourgogne-Franche Comté, LipSTIC LabEx, F-21000 Dijon, France. 4. Department of Epidemiology, Dijon University Hospital, 21000 Dijon, France. 5. Department of Cardiac Surgery, Dijon University Hospital, F-21000 Dijon, France. 6. Department of Anesthesiology and Intensive Care, Dijon University Hospital, F-21000 Dijon, France; University of Burgundy and Franche-Comté, LNC UMR1231, F-21000 Dijon, France; INSERM, LNC UMR1231, F-21000 Dijon, France; FCS Bourgogne-Franche Comté, LipSTIC LabEx, F-21000 Dijon, France. 7. Department of Anesthesiology and Intensive Care, Dijon University Hospital, F-21000 Dijon, France; University of Burgundy and Franche-Comté, LNC UMR1231, F-21000 Dijon, France. 8. University of Burgundy and Franche-Comté, LNC UMR1231, F-21000 Dijon, France; INSERM, LNC UMR1231, F-21000 Dijon, France; FCS Bourgogne-Franche Comté, LipSTIC LabEx, F-21000 Dijon, France; AgroSup, LNC UMR1231, F-21000 Dijon, France.
Abstract
INTRODUCTION: Cardiac surgery with cardiopulmonary bypass (CPB) is associated with gut barrier dysfunction. Gut barrier dysfunction might be estimated non-invasively by lipopolysaccharide (LPS) plasma concentration. Glucagon-like peptide-1 (GLP-1) is a gut secreted hormone that is a potential marker of mucosal integrity. Our objective was to evaluate GLP-1 as a peri-operative marker of gut barrier dysfunction in patients undergoing cardiac surgery with CPB. METHODS: GLP-1, intestinal fatty acid binding protein (I-FABP) and lipopolysaccharide were assayed: at induction, after CPB and 24 h after admission in the intensive care unit. The primary end-point was peri-operative lipopolysaccharide concentration (LPS concentration at those 3 time points). RESULTS: Seventy-two patients were included in the present analysis. The highest measured post-operative GLP-1 concentration was in the sample taken 24 h after admission to intensive care, which was associated with peri-operative lipopolysaccharide plasma concentration. Patients who had the highest GLP-1 concentrations at 24 h experienced more severe inflammation and worse clinical outcomes. CONCLUSION: Our study supports that GLP-1 is not only a hormone of glucose metabolism but is also secreted when gut barrier is impaired in cardiac surgery with CPB. The GLP-1 levels measured 24 h after admission to the intensive care unit were associated with LPS concentration, inflammation and clinical outcomes.
INTRODUCTION: Cardiac surgery with cardiopulmonary bypass (CPB) is associated with gut barrier dysfunction. Gut barrier dysfunction might be estimated non-invasively by lipopolysaccharide (LPS) plasma concentration. Glucagon-like peptide-1 (GLP-1) is a gut secreted hormone that is a potential marker of mucosal integrity. Our objective was to evaluate GLP-1 as a peri-operative marker of gut barrier dysfunction in patients undergoing cardiac surgery with CPB. METHODS:GLP-1, intestinal fatty acid binding protein (I-FABP) and lipopolysaccharide were assayed: at induction, after CPB and 24 h after admission in the intensive care unit. The primary end-point was peri-operative lipopolysaccharide concentration (LPS concentration at those 3 time points). RESULTS: Seventy-two patients were included in the present analysis. The highest measured post-operative GLP-1 concentration was in the sample taken 24 h after admission to intensive care, which was associated with peri-operative lipopolysaccharide plasma concentration. Patients who had the highest GLP-1 concentrations at 24 h experienced more severe inflammation and worse clinical outcomes. CONCLUSION: Our study supports that GLP-1 is not only a hormone of glucose metabolism but is also secreted when gut barrier is impaired in cardiac surgery with CPB. The GLP-1 levels measured 24 h after admission to the intensive care unit were associated with LPS concentration, inflammation and clinical outcomes.