Article (Scientific journals)
Cytokine balance in infants undergoing cardiac operation.
Hovels-Gurich, Hedwig H; Schumacher, Kathrin; Vazquez-Jimenez, Jaime F et al.
2002In Annals of Thoracic Surgery, 73 (2), p. 601-8; discussion 608-9
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Keywords :
Acute-Phase Proteins/metabolism; Anoxia/immunology/surgery; Cardiopulmonary Bypass; Cytokines/blood; Female; Heart Arrest, Induced; Heart Defects, Congenital/immunology/surgery; Heart Failure/immunology/surgery; Humans; Infant; Male; Postoperative Complications/immunology; Risk Factors; Systemic Inflammatory Response Syndrome/immunology
Abstract :
[en] BACKGROUND: The control of the systemic inflammatory response taking place during cardiac operations depends on adequate antiinflammatory reaction. In this prospective study we tested the hypothesis that cytokine balance during pediatric cardiac surgical procedures would be influenced by the patients' preoperative clinical condition, defined as hypoxemia or heart failure. METHODS: Twenty infants (median age, 8 months) with hypoxemia owing to intracardiac right-to-left shunt (group 1, n = 10) or with heart failure because of intracardiac left-to-right shunt (group 2, n = 10), scheduled for elective primary corrective operation, were enrolled. Plasma levels of the proinflammatory cytokine interleukin (IL) 6, the natural antiinflammatory cytokine IL-10, and the markers of the acute-phase response, C-reactive protein and procalcitonin, were sequentially measured before, during, and after cardiac operation up to the 10th postoperative day. The ratio of IL-10 to IL-6 levels served as a marker for the individual's antiinflammatory cytokine balance. RESULTS: Group 1 showed higher preoperative IL-6 (p < 0.001), lower IL-10 levels (p < 0.02), and lower ratio of IL-10 to IL-6 levels (p < 0.001) than group 2. Preoperative C-reactive protein and procalcitonin were not detectable. In group 1, preoperative IL-6 levels inversely correlated with preoperative oxygen saturation (Spearman correlation coefficient, -0.74, p < 0.02). During cardiopulmonary bypass, IL-6 levels were higher, whereas IL-10 and ratio of IL-10 to IL-6 levels were lower in group 1 than in group 2. In all patients, postoperative IL-6 levels were positively correlated with duration of inotropic support and serum creatinine value and inversely correlated with oxygenation index and diuresis. CONCLUSIONS: Infants with hypoxemia show a preoperative inflammatory state with low antiinflammatory cytokine balance in contrast to those with heart failure. This in turn is associated with lower perioperative antiinflammatory cytokine balance and might contribute to postoperative morbidity.
Disciplines :
Pediatrics
Author, co-author :
Hovels-Gurich, Hedwig H;  Rheinisch - Westfälische Technische Hochschule Aachen - RWTH > Pediatric Cardiology
Schumacher, Kathrin;  Rheinisch - Westfälische Technische Hochschule Aachen - RWTH > Pediatric Cardiology
Vazquez-Jimenez, Jaime F;  Rheinisch - Westfälische Technische Hochschule Aachen - RWTH > Pediatric Cardiac Surgery
Qing, Ma;  Rheinisch - Westfälische Technische Hochschule Aachen - RWTH > Pediatric Cardiology
Huffmeier, Ulrike;  Rheinisch - Westfälische Technische Hochschule Aachen - RWTH > Pediatric Cardiology
Buding, Brigitte;  Rheinisch - Westfälische Technische Hochschule Aachen - RWTH > Anesthesiology
Messmer, Bruno J;  Rheinisch - Westfälische Technische Hochschule Aachen - RWTH > Thoracic and Cardiovascular Surgery
von Bernuth, Gotz;  Rheinisch - Westfälische Technische Hochschule Aachen - RWTH > Pediatric Cardiology
SEGHAYE, Marie-Christine ;  Rheinisch - Westfälische Technische Hochschule Aachen - RWTH > Pediatric Cardiology
Language :
English
Title :
Cytokine balance in infants undergoing cardiac operation.
Publication date :
February 2002
Journal title :
Annals of Thoracic Surgery
ISSN :
0003-4975
eISSN :
1552-6259
Publisher :
Elsevier, Amsterdam, Netherlands
Volume :
73
Issue :
2
Pages :
601-8; discussion 608-9
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 27 February 2012

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