The Utility of Urine Desmosine as a Marker of Lung Injury in Spine Surgery


Stavros G. Memtsoudis, MD, PhD

Attending Anesthesiologist, Hospital for Special Surgery
Clinical Professor of Anesthesiology, Weill Cornell Medical College
Clinical Professor of Public Health, Weill Cornell Medical College

Michael K. Urban, MD, PhD

Associate Attending Anesthesiologist, Hospital for Special Surgery

Federico P. Girardi, MD

Associate Attending Orthopaedic Surgeon, Hospital for Special Surgery
Associate Professor of Orthopedics, Weill Cornell Medical College
Associate Scientist, Research Division, Hospital for Special Surgery


Barry Starcher, PhD
Department of Biochemistry, University of Texas Health Center

Yan Ma, PhD
Department of Epidemiology and Biostatistics, Hospital for Special Surgery
Weill Cornell College of Cornell University

Valeria Buschiazzo
Department of Anesthesiology, Hospital for Special Surgery

Abstract

The objective of this prospective observational study was to determine if urine desmosine levels, a marker of lung injury, increase in response to the periopreative insults of anterior and posterior spine surgery. Desmosine, a stable breakdown product of elastin, has been proposed as a surrogate marker of lung injury in patients with COPD, tobacco use, and ARDS. We recently evaluated this marker in patients undergoing knee surgery, but the utility of desmosine as a marker of lung injury in patients undergoing spine surgery remains unstudied. In this study, we enrolled ten consecutive patients, who underwent anterior/posterior spine surgery. Patient demographics and perioperative data were recorded. Urine samples were collected at baseline, 1 day, and 3 days postoperatively and analyzed for levels of desmosine using a previously validated radioimmunoassay. Desmosine levels were 35.9#±#18.2 pmol/mg creatinine at baseline, 38.7#±#11 pmol/mg creatinine on postoperative day#1, and 70.5#±#49.1 pmol/mg creatinine on postoperative day#3, respectively. Desmosine/creatinine ratios measured on day#3 postoperatively were significantly elevated compared to levels at baseline, and represented a 96.3% increase. No difference was seen between levels at baseline and day#1 postoperatively. In conclusion, we were able to show a significant increase in urine desmosine levels associated with anterior/posterior spine surgery. In the context of previous studies, our findings suggest that desmosine may be a marker of lung injury in this setting. However, further research is warranted for validation and correlation of desmosine levels to clinical markers and various degrees of lung injury.

This article appears in HSS Journal: Volume 6, Number 2.
View the full article at springerlink.com.

About the HSS Journal

HSS Journal, an academic peer-reviewed journal, is published twice a year, February and September, and features articles by internal faculty and HSS alumni that present current research and clinical work in the field of musculoskeletal medicine performed at HSS, including research articles, surgical procedures, and case reports.

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