PT - JOURNAL ARTICLE AU - Lucio Cagini AU - Marco Andolfi AU - Rossella Potenza AU - Silvia Ceccarelli AU - Jacopo Vannucci AU - Gianpaolo Reboldi AU - Vito Aldo Peduto AU - Francesco Puma TI - Microalbuminuria as a predictor of cardiopulmonary complications after thoracic surgery AID - 10.1183/13993003.congress-2015.PA2514 DP - 2015 Sep 01 TA - European Respiratory Journal PG - PA2514 VI - 46 IP - suppl 59 4099 - http://erj.ersjournals.com/content/46/suppl_59/PA2514.short 4100 - http://erj.ersjournals.com/content/46/suppl_59/PA2514.full SO - Eur Respir J2015 Sep 01; 46 AB - Introduction: Microalbuminuria (MA) reflects the systemic vascular endothelial dysfunction and could have a role in early identification of systemic inflammatory response syndrome (SIRS) and multiple organ failure.Aims and Objectives: Aim of this study was to serially assess MA after thoracic surgery and to evaluate its role in predicting complications.Methods: Prospective observational study, including patients undergoing 183 major proceedures and 72 wedge resections. MA was expressed as urine albumin-to-creatinine ratio (A/C) before and after surgery at predefined times up to 96 hours and Pa/FiO2 measured at extubation and at first postoperative day.Results: 255 patients, mean age 62, 67% male. The most common comorbidities were COPD 44%, hypertension 39% and diabetes 11%. Preoperative A/C levels were within the normal range but showed a significant increase at extubation reaching a peak 6 hours later p<0.001. At extubation A/C was inversely related with PaO2/FiO2 ratio r=-0.25; p=0.038. 3% had MODS>4 requiring intensive care. 2 patients died and 35 experienced cardiopulmopnary complications. A higher A/C ratio was recorded in patients who developed adverse events compared to the group with uneventful course (p<0.019). Peak A/C>61mg/g (ROC area=0.669; 95% CI=0.599-0.734; p=0.0003) was associated with cardio-pulmonary impairments (OR 3.85; 95%CIs 1.58-9.36; p=0.003).Conclusions: MA might be and early marker of posoperative increased vascular permeability showing an inverse correlation with PaO2/FiO2 ratio. It could be a useful diagnostic tool for identification of patients at risk for cardiopulmonary complications; its independent prognostic significance remains to be established.