Anestéziológia a intenzívna medicína 1/2014

Neutrophil-lymphocyte ratio as a possible marker of SIRS in patients after cardiac surgery procedures

Objective: To evaluate the dynamics of the neutrophils’ and lymphocytes‘ blood counts (e. g. neutrophil-lymphocyte ratio – NLR) and their significance as a predictor of postoperative outcome after cardiac surgery procedures. Material and methods: 93 patients were included in our observational study undergoing elective or semielective cardiac surgery with cardiopulmonary bypass. Blood was taken 6 times to evaluate the counts of neuthrophils and lymphocytes. Other parameters concerning patient, operation and postoperative outcome were noticed as well. Results: NLR increases rapidly after operation and peaks in the evening of the day of the operation. Subsequently NLR begins to decrease slower not reaching its preoperative value by the day 3 postoperatively. The only statistically significant day was postoperative day 2, when values of NLR of 7,23 and 11,27 meant different patient, procedure or outcome parameters. Conclusion: Our study described the course of the NLR after cardiac surgery. Although the values on the day 2 seem significant, we can not make definitive conclusions due to the small size of our study. Additional studies are needed to elucidate the clinical significance of the NLR.

Keywords: neutrophil-lymphocyte ratio, differential blood count, cardiopulmonary bypass, cardiac surgery.