RT Journal Article SR Electronic T1 Microalbuminuria as a predictor of cardiopulmonary complications after thoracic surgery JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP PA2514 DO 10.1183/13993003.congress-2015.PA2514 VO 46 IS suppl 59 A1 Lucio Cagini A1 Marco Andolfi A1 Rossella Potenza A1 Silvia Ceccarelli A1 Jacopo Vannucci A1 Gianpaolo Reboldi A1 Vito Aldo Peduto A1 Francesco Puma YR 2015 UL http://erj.ersjournals.com/content/46/suppl_59/PA2514.abstract 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.