Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-24T14:30:33.675Z Has data issue: false hasContentIssue false
  • English
  • Français

Cytokines and pediatric open heart surgery with cardiopulmonary bypass

Published online by Cambridge University Press:  01 July 2011

Marcus V. H. Carvalho ,
Miguel A. Maluf ,
Roberto Catani ,
Carlos A. A. La Rotta ,
Walter J. Gomes ,
Reinaldo Salomão ,
Célia M. da Silva ,
Antonio C.C. Carvalho ,
João N. R. Branco  and
Enio Buffolo
Marcus V. H. Carvalho
Affiliation:
Division of Cardiac Surgery, Federal University of Saão Paulo – Escola Paulista de Medicina, São Paulo, Brasil
Miguel A. Maluf
Affiliation:
Division of Cardiac Surgery, Federal University of Saão Paulo – Escola Paulista de Medicina, São Paulo, Brasil
Roberto Catani
Affiliation:
Division of Cardiac Surgery, Federal University of Saão Paulo – Escola Paulista de Medicina, São Paulo, Brasil
Carlos A. A. La Rotta
Affiliation:
Division of Cardiac Surgery, Federal University of Saão Paulo – Escola Paulista de Medicina, São Paulo, Brasil
Walter J. Gomes
Affiliation:
Division of Cardiac Surgery, Federal University of Saão Paulo – Escola Paulista de Medicina, São Paulo, Brasil
Reinaldo Salomão
Affiliation:
Division of Infectious Diseases, Federal University of São Paulo – Escola Paulista de Medicina, São Paulo, Brasil
Célia M. da Silva
Affiliation:
Division of Cardiology, Federal University of São Paulo – Escola Paulista de Medicina, São Paulo, Brasil
Antonio C.C. Carvalho
Affiliation:
Division of Cardiology, Federal University of São Paulo – Escola Paulista de Medicina, São Paulo, Brasil
João N. R. Branco*
Affiliation:
Division of Cardiac Surgery, Federal University of Saão Paulo – Escola Paulista de Medicina, São Paulo, Brasil
Enio Buffolo
Affiliation:
Division of Cardiac Surgery, Federal University of Saão Paulo – Escola Paulista de Medicina, São Paulo, Brasil
*
Correspondence to: Prof Dr J N R Branco, Disciplina de Cirurgia Cardiovascular, Federal University of S©o Paulo – Escola Paulista de Medicina, R. Napoleao de Barros, 715 – CEP 04024–002 – São Paulo / Brasil. Tel: 55 011 576 4055; Fax: 55 11 571 2719
Get access Rights & Permissions [Opens in a new window]

Abstract

It is well known that, subsequent to cardiopulmonary bypass, and particularly in children, an inflammatory response within the body can often result in a characteristic syndrome. Recently, it has been suggested that this phenomenon is due to a systemic inflammatory response, with significant involvement of cytokines. With this in mind, we investigated the behavior of tumour necrosis factor-α and interleukin–6 during the operative and in the immediate postoperative period in a group of children submitted to open heart surgery. We investigated any possible relation between the levels of these cytokines in the serum and the length of cardiopulmonary bypass, with the serum levels of lactate, and with the extent of use of inotropic drugs in postoperative period. The cytokines were measured in samples withdrawn after induction of anesthesia, after 10 minutes of cardiopulmonary bypass, after re-establishment of circulation, and then 2 and 24 hours after the end of cardiopulmonary bypass. The levels of tumour necrosis factor-α and interleukin–6 increased between the beginning and at two hours of the end of cardiopulmonary bypass. There was no correlation between the levels of these cytokines in the serum and the length of cardiopulmonary bypass, although there was a positive relation between levels of interleukin–6 and lactate in samples withdrawn at two hours of the end of bypass, and the measured levels of the cytokines correlated with the extent of inotropic drugs employed in the postoperative period.

Keywords

cardiopulmonary bypasscytokines: tumour necrosis factor-α and interleukin–6surgerycardiacpediatric
Type
Original Articles
Information
Cardiology in the Young , Volume 11 , Issue 1 , January 2001 , pp. 36 - 43
Copyright
Copyright © Cambridge University Press 2001

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Jansen, NJG, van Oeveren, W, Broek, LVD et al. , Inhibition by dexamethasone of the reperfusion phenomena in cardiopulmonary bypass. J Thorac Cardiovasc Surg 1991;102:515–525.Google Scholar
2.Butler, J, Pathi, VL, Paton, RD et al. , Acute-phase responses to cardiopulmonary bypass in children weighing less than 10 kilograms. Ann Thorac Surg 1996;62:538–542.Google Scholar
3.Finn, A, Naik, S, Klein, N, Levinsky, RL, Strobel, S, Elliott, M. Interleukin—8 release and neutrophil degranulation after pediatric cardiopulmonary bypass. J Thorac Cardivasc Surg, 1993;105:234–241.Google Scholar
4.Brasil, LA, Gomes, WJ, Salomão, R, Buffolo, E. Ativação de Citocina (fator de necrose tumoral-α) e resposta clinica induzida pela circulação extracorpórea. Rev Bras Cir Cardiovasc, 1996;ll:188–200.Google Scholar
5.Tàrnok, A, Hambsch, J, Schneider, PCardiopulmonary bypassinduced increase of serum interleukin-10 levels in children. J Thorac Cardiovasc Surg 1998;115:475–477.Google Scholar
6.Teoh, KHT, Bradley, CA, Gauldie, J, Burrows, H. Steroid inhibition of cytokine-mediated vasodilatation after warm heart surgery. Circulation 1995;92(2):347–353.CrossRefGoogle ScholarPubMed
7.Seghaye, MC, Grabitz, RG, Duchateau, J et al. , Inflammatory reaction and capillary leak syndrome related to cardiopulmonary bypass in neonates Undergoing Cardiac Operations. J Thorac Cardiovasc Surg 1996;112:687–697.CrossRefGoogle ScholarPubMed
8.Casey, WF, Hauser, GJ, Hannalah, RS, Midgley, FM, Khan, TO. Circulating endotoxin and tumor necrosis factor during pediatric cardiac surgery. Crit Care Med 1992;20:1090–1096.CrossRefGoogle ScholarPubMed
9.Behr, D, Hernvann, A, Pouard, P et al. , Interleukin-6 and Creactive protein during pediatric cardiopulmonary bypass. Clin Chemistry 1995;41:467–469.Google Scholar
10.Tang, GJ, Kuo, CD, Yen, TC et al. , Perioperative plasma concentrations of tumor necrosis factor-α and interleukin—6 in infected patients. Crit Care Med 1996;24:423–28.Google Scholar
11.Hack, CE, De Groot, ER, Felt-Bersma, RJF et al. , Increased plasma levels of interleukin-6 in sepsis. Blood, 1989, 74:1704–1710.Google Scholar
12.Millar, AB, Armstrong, L, Van Der Linden, J et al. , Cytokine production and hemofiltration in children undergoing cardiopulmonary bypass. Ann Thorac Surg, 1993; 56; 1499–502.CrossRefGoogle ScholarPubMed
13.Duval, ELIM, Kavelaars, A, Veenhuizen, L, van Vught, AJ, van de Wai, HJCM, Heijnen, CJ. Cytokine patterns during and after cardiac surgery in young children. Intensive Care Medic 1996; 22 (suppl. 2):232.Google Scholar
14.Gu, YJ, De Vriers, AJ, Boonstra, PW, Van Oeveren, W. Leukocyte depletion results in improved lung function and reduced inflammatory response after cardiac surgery. J Thorac Cardivasc Surg 1996; 112:494–500.CrossRefGoogle ScholarPubMed
15.Hennein, HA, Ebba, H, Rodriguez, JL et al. , Relationship of the proinflammatory cytokines to myocardial ischemia and dysfunction after uncomplicated coronary revascularization. J Thorac Cardiovasc Surg 1994;108;626–635.CrossRefGoogle ScholarPubMed
16.Markewitz, A, Faist, E, Lang, S, Endress, S, Fuchs, D, Reichart, B. Successful restoration of cell-mediated immune response after cardiopulmonary bypass by immuno modulation. J Thorac. Cardiovasc Surg 1993;105:15–24.Google Scholar
17.Journois, D, Pouard, P, Greeley, WJ, Mauriat, P, Vouh, P, Safran, D. Hemofiltration during cardiopulmonary bypass in pediatric cardiac surgery. Anesthesiology 1994;81:1181–1189.Google Scholar
18.Ito, H, Hamano, K, Gohra, H et al. , Relationship between respiratory distress and cytokine response after cardiopulmonary bypass. Jpn J Surg 1997;27:220–225.Google ScholarPubMed
19.Ridley, PD, Ratcliffe, JM, Albrti, KGMM, Elliot, MJ. The metabolic consequences of a ‘washed’ cardiopulmonary bypass pump-priming fluid in children undergoing cardiac operations. J Thorac Surg 1990;100:528–537.CrossRefGoogle ScholarPubMed