5; Haemodynamic stability (small dosage of vasopressor support and mean arterial pressure within 10–15% of baseline); Tipifarnib side effects No severe arrhythmias; No bleeding or indications of re-exploration. The patient’s endotracheal tube is removed if he/she achieves

the criteria. Patients are discharged from the ICU after successful extubation. In our clinical practice, blood samples are routinely obtained for whole blood assessment prior to and 1 day after the operation. PCT is also assessed prior to and 1 day after the operation. N-terminal pro-B-type natriuretic peptide (Nt-pro-BNP) and CRP levels are assessed 1 day after the operation. A chest X-ray is routinely obtained prior to the operation as well as 1 and 7 days after the operation. Additional chest X-ray examinations are performed

if patients exhibit hypoxia due to suspicious infection, pulmonary atelectasis, pleural effusion or ARDS. A blood gas analysis is performed at least once daily when the patients are in the ICU. After they are transferred to a normal room, a blood gas analysis is performed when deemed necessary by the physicians or when patients’ SpO2 cannot be maintained at a level greater than 95% with a FiO2 of 0.5. Follow-up and data collection This is an observational study wherein no intervention is applied. At study entry, data regarding patient demographics, history of smoking, history of past illness patient characteristics, diagnosis and the New York Heart Association (NYHA) functional classification16 are collected. The type of surgery, duration of operation, CPB and aortic clamping, and net fluid balance during the operation are recorded. Serum CRP, Nt-pro-BNP and PCT concentrations are also recorded on the first postoperative day. Patients are assigned to the

PCT elevated cohort or control cohort based on serum PCT concentrations on the first postoperative day using a cut-off value of 7.0 ng/mL. Daily fluid balance and highest vasoactive-inotropic score (VIS) are calculated. VIS is calculated as dopamine dose (μg/kg/min)+dobutamine dose (μg/kg/min)+100×epinephrine Brefeldin_A dose (μg/kg/min)+100×norepinephrine dose (μg/kg/min)+15×milrinone dose (μg/kg/min)+10 000×vasopressin dose (U/kg/min).17 Data are collected until the seventh day after the operation. ARDS is diagnosed according to the Berlin definition.18 A checklist (table 1) is used to assess the development of moderate to severe ARDS. Two physicians make the diagnosis independently. Only patients diagnosed with moderate to severe ARDS by both physicians are considered. Echocardiography or pulmonary artery catheter (PAC) is applied to exclude hydrostatic oedema. Physicians who assess the development of ARDS are unaware of the patient’s PCT level.