Extracorporeal circulation causes release of neutrophil gelatinase-associated lipocalin (NGAL)

EXTRACORPOREAL circulation (ECC) used during cardiac surgery causes activat ion of several inflammatory systems. These events are not fully understood but are responsible for complications during the immediate postoperative pe riod. Neutrophil gelatinase-associated lipocalin (NGAL), a member of the ex panding lipocalin family, has recently been described as an inflammatory pr otein. In this study, the release of NGAL, into the circulation in 41 patie nts undergoing heart surgery with ECC was evaluated, A 4- to 5-fold elevati on of the concentration of NGAL in plasma was observed during the immediate postoperative course with a rapid elimination during the first postoperati ve day. Four patients undergoing lung surgery (without ECC) were also studi ed, The plasma concentration of NGAL only increased with a factor of 1.1-2. 2 over the operation. We conclude that NGAL is released into the circulatio n during heart surgery, probably as a result of the inflammatory activation of leukocytes initiated by the extracorporeal circulation.