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. 2024 Feb;95(3):770-774.
doi: 10.1038/s41390-023-02915-5. Epub 2023 Nov 25.

sTREM2 in the prognostic evaluation of acute lung injury after cardiac surgery in infants

Lijun Yang #  1 , Mingwei Sun #  1 , Liyang Ying  2 , Xiwang Liu  2 , Wenting Zhao  1 , Ru Lin  1 , Qiang Shu  3
Affiliations

sTREM2 in the prognostic evaluation of acute lung injury after cardiac surgery in infants

Lijun Yang et al. Pediatr Res. 2024 Feb.

Abstract

Background: Previous studies have shown that TREM2 plays a protective role in acute lung injury (ALI). This prospective study aimed to investigate the role of sTREM2 as a forecasting factor for ALI in infants after pediatric cardiac surgery undergoing cardiopulmonary bypass (CPB).

Methods: Seventy-five consecutive patients younger than 1 year who underwent cardiac surgery were enrolled in this study. Sixty-one fulfilled the inclusion criteria and had been divided into ALI and non-ALI groups. Children's demographic characteristics and clinical data were collected. Perioperative sTREM2 levels were analyzed at five timepoints.

Results: In this study, children in the ALI group were younger, lighter, with higher RACHS-1 scores and underwent significantly longer CPB time. Post-CPB ALI had an impact on clinical outcomes, which contributed to a longer duration of mechanical ventilation, ICU and hospital stay than non-ALI group. Significant differences were manifested off-CPB, 1 h/6 h after CPB, and day 1 after surgery between the two groups. Binary logistic models revealed that off-CPB sTREM2 was significantly associated with the incidence of post-CPB ALI after adjustment. ROC analysis showed that the AUC of off-CPB sTREM2 level was 0.791, and the optimal cutoff value was 788.6 pg/ml.

Conclusions: The off-CPB sTREM2 level was an independent prognostic factor for post-CPB ALI in infants.

Impact: Plasma sTREM2 works together with downstream TREM2 to regulate inflammation response by binding the receptor to other cells. Previous studies have shown that TREM2 plays a protective role in ischemia-reperfusion and has anti-inflammatory effects on acute lung injury (ALI). This study analyzed the risk factors of post-cardiopulmonary bypass (CPB) ALI. We found that weight and off-CPB sTREM2 level were independent prognostic factors for post-CPB ALI. Plasma sTREM2 may serve as an early biomarker in the prognostic evaluation of acute lung injury after cardiac surgery in infants.

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