Biomarkers receive increasing attendance as signals of morbidity. Haemoscan has in particular developed organ damage biomarkers, since these directly represent areas of clinical relevance.
In 2009, the company showed the association of haemodilution and transfusion of red blood cells with biochemical markers of splanchnic and renal injury during cardiopulmonary bypass. Kidney and splanchnic ischemia were assessed by the measurement of N-acetyl-beta-D-glucosaminidase (NAG) and intestinal fatty acid binding protein (IFABP) in urine. The results support the concept that haemodilution below an intraoperative hematocrit of 24% and consequently transfusion of red blood cells is related to release of injury markers of the kidneys and splanchnic area.
Glomerular and tubular damage markers appeared to have predictive value for the development of progressive albuminuria. This study investigated whether assessment of urinary markers associated with damage to different parts of the nephron may help identify individuals that will progress in albuminuria.
Urinary excretion of the glomerular damage marker IgG was significantly higher in progressors, whereas urinary excretion of proximal tubular damage markers and inflammatory markers was lower in these individuals compared with controls. Healthy individuals (n=109) had the lowest values for all urinary damage markers measured. These data suggest that albuminuria associated with markers of glomerular damage is more likely to progress, whereas albuminuria associated with markers of tubulointerstitial damage is more likely to remain stable.
After impaired blood circulation and blood activation brain damage may occur. Haemoscan measured carnosinase and Brain Fatty Acid Binding Protein (BFABP) in coronary artery bypass grafting patients. A minimised perfusion circuit showed a significant higher and stable serum carnosinase activity during extracorporeal circulation as compared with conventional circulatory perfusion bypass due to less haemodilution and a better-preserved oxygen capacity. As a consequence, the antioxidant stress during minimised perfusion circuit is limited as compared with conventional circulatory perfusion, which means less brain tissue damage reflected by a lower BFABP release.
Biomarkers of lung injury in cardiothoracic surgery were developed by Haemoscan in 2015.
Diagnosis of pulmonary dysfunction is currently almost entirely based on a vast series of physiological changes, but comprehensive research is focused on determining biomarkers for early diagnosis of pulmonary dysfunction. In this review paper, Haemoscan discussed the use of biomarkers of lung injury in cardiothoracic surgery and their ability to detect subtle pulmonary dysfunction in the perioperative period. Degranulation products of neutrophils are often used as biomarker since they have detrimental effects on the pulmonary tissue by themselves. However, these substances are not lung specific. Lung epithelium-specific proteins offer more specificity and slowly find their way into clinical studies.