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Eur J Cardiothorac Surg 2007;32:950-951. doi:10.1016/j.ejcts.2007.09.019
Copyright © 2007, European Association for Cardio-thoracic Surgery. Published by Elsevier. All rights reserved.
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Letters to the Editor

Reply to Paleari et al.

David Amara,*, Bernard Parkb, Paul M. Heerdta

a Department of Anesthesiology and Critical Care Medicine, Memorial Sloan-Kettering Cancer Center and Weill Medical College of Cornell University, New York, NY, United States
b Department of Surgery, Memorial Sloan-Kettering Cancer Center and Weill Medical College of Cornell University, New York, NY, United States

Received 20 September 2007; accepted 21 September 2007.

* Corresponding author. Address: Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, M-304, New York, NY 10021, United States. Tel.: +1 212 639 6798; fax: +1 212 772 8646. (Email: amard{at}mskcc.org).

Key Words: Albumin • C-reactive protein • Interleukin-6

We thank Dr Paleari et al. [1] for their interest in our work. CRP and IL-6 are relatively non-specific and represent only a small part of the complex pro- and anti-inflammatory response to surgery, and yes, the pre-existing insult of COPD (and other diseases) imposes an additional burden. Nonetheless, the data showed a prominent association of elevated CRP and IL-6 levels to identify high-risk patients and we doubt that this is an epiphenomenon. We welcome Dr Paleari and colleagues’ suggestion to find an ‘accurate and diagnostic test for sepsis, etc.’ but sepsis was not the focus of our paper.

References

  1. Paleari L, Russo P, Cesario A, Granone P. Inflammation and thoracic surgery: a complex interaction. Eur J Cardiothorac Surg 2007;32:950.[Free Full Text]




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Bernard Park
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