Dramatic increase in serum trypsinogens, SPINK1 and hCGβ in aortic surgery patients after hypothermic circulatory arrest

Figures & data

Figure 1. Time course of the changes in concentrations of the markers after hypothermic circulatory arrest (median and interquartile range, n = 16–17 for days 0–7 and n = 8–9 for day 8–10, except for hCG n = 11 and 6, respectively). Day 0 is the baseline sample, collected right before anesthesia induction. Dashed lines show the upper reference limit of the markers. *The upper reference limit for hCG varies between 1 and 7 IU/l depending on age and gender (see Table 1). One outlier value of trypsin-2–API has been removed.

Table 1. The baseline and postoperative concentrations of the studied markers.

	Baseline (day 0)	Peak concentration^a	p Value^b	Upper ref.
	median (n, IQR)	median (IQR)	baseline vs. max	limit^c
S100β (µg/l)	0.05 (17, 0.03–0.06)	0.23 (0.14–0.38)	<.001	0.11
NSE (µg/l)	12 (17, 10–14)	44 (34–59)	<.001	16
Amylase (U/l)	41 (17, 28–68)	113 (65–224)	<.001	120
Trypsinogen-1 (µg/l)	33 (17, 18–42)	87 (52–243)	.001	70
Trypsinogen-2 (µg/l)	27 (17, 14–40)	305 (85–597)	<.001	90
Trypsinogen-3 (µg/l)	0.56 (16, 0.01–1.48)	3.7 (1.5–12.4)	.004	1.2
Trypsin-2–API (µg/l)^d	5.3 (16, 3.9–9.7)	34 (18–87)	<.001	25
SPINK1 (µg/l)	11 (17, 9–19)	123 (83–362)	<.001	16.2
hCG (IU/l)	0.23 (11, 0.14–0.52)	0.44 (0.13–0.82)	.859	1–7^e
hCGβ (pmol/l)	0.54 (17, 0.41–0.85)	3.1 (2.1–8.3)	<.001	2

^aHighest observed concentrations during the follow-up period.

^bWilcoxon signed-rank test, baseline vs. highest levels.

^cUpper reference limits.

^dOne outlier value of trypsin-2–API has been removed from analyses.

^eUpper reference limit for hCG is 3 IU/l for women <50 years of age and 7 IU/l for those >50 years, and 1 IU/l for men <60 years and 2 IU/l for those >60 years of age.