Peri-operative Inflammation and AKI/PPCs following abdominal surgery
Research type
Research Study
Full title
The association between the Peri-operative Inflammation and Acute Kidney Injury/Postoperative Pulmonary Complications following major abdominal surgery
IRAS ID
269484
Contact name
Jaimin Patel
Contact email
Sponsor organisation
University of Birmingham
Duration of Study in the UK
3 years, 0 months, 1 days
Research summary
Tissue injury is unavoidable during surgical procedures and induces an inflammatory response in the patient. The innate immune system has main effector cells such as neutrophils, which contribute to defense against invading, exogenous pathogens (Phillipson and Kubes, 2011). The recruitment and activation of neutrophils can also occur during aseptic (sterile) inflammation, including excessive tissue damage and ischemia-reperfusion injury following the major surgery (Fudulu and Angelini, 2016). Tissue trauma following the surgery has been revealed to specifically induce NET formation (McIlroy et al., 2014).These circulating NETs are cytotoxic, and may cause endothelial cell and glycocalyx damage leading to a subsequent impairment of vascular endothelial integrity and increased vascular permeability (Saffarzadeh et al., 2012). This leads to tissue oedema and increases the risk of postoperative end-organ dysfunction, such as acute lung and kidney injury.
Acute kidney injury (AKI) is a common occurrence in hospitalized patients and is associated with adverse patient outcomes. Several studies using modern standardized classifications for AKI stated a variable incidence of AKI after major abdominal surgery ranging from 3 to 35% (Abelha et al., 2009, Kheterpal et al., 2007, Causey et al., 2011, Cho et al., 2011). It is considered a major cause of increased morbidity and mortality among patients undergoing major surgical interventions worldwide, and contributes to increased length of hospital stay and cost of treatments (Raji et al., 2018).
This a single centre, prospective observational study design will investigate peri-operative inflammation to establish whether it is linked to AKI and postoperative pulmonary complications (PPCs) among patients undergoing major abdominal surgery. This investigation will help to find whether any therapeutic interventions are possible to reduce these adverse events.
REC name
West Midlands - Coventry & Warwickshire Research Ethics Committee
REC reference
20/WM/0006
Date of REC Opinion
19 Mar 2020
REC opinion
Further Information Favourable Opinion