Early prediction of capillary leak syndrome in infants after cardiopulmonary bypass†

Kubicki, Rouven; Grohmann, Jochen; Siepe, Matthias; Benk, Christoph; Humburger, Frank; Rensing‐Ehl, Anne; Stiller, Brigitte

doi:10.1093/ejcts/ezt028

Cited by 27 publications

(15 citation statements)

References 23 publications

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“…There are three kinds of course inclusive of classical pathway, alternative pathway and lection pathway, which activated by many factor that much protein in a complement system in sequence. To the best of our knowledge, cardiopulmonary bypass can result in a post-CPB syndrome that is characterized by increased vascular permeability, generalized edema, pulmonary dysfunction, and cardiac dysfunction [3][4][5]. This syndrome seems to be more intense in neonates and can result in prolonged ventilation, coagulopathy, postcardiotomy cardiac failure, and increased mortality.…”

Section: Discussionmentioning

confidence: 99%

C1 esterase inhibitor in pediatric cardiac surgery with cardiopulmonary bypass plays a vital role in activation of the complement system

et al. 2019

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Our prospective study was therefore designed to determine which part of the systemic inflammatory response after cardiac operations resulted from Cardiopulmonary bypass (CPB) in neonates and infants. After approval by the human ethical committee of the Gunma Children's Medical Center (GCMC) and informed consent of the parents, 40 consecutive term congenital heart disease patients aged until 1 year who underwent long CPB time (> 3 h) at surgery were included in the prospective study between January 2012 and December 2014. C1 esterase inhibitor (C1-inh) drug (@Berinert) was generously provided by CSL Behring (King of Prussia, PA). The C1-inh (20 IU/kg) was given intravenously 60 min after CPB. Blood samples for complement factors were obtained before and 48 h after administration of C1-inh. Six patients did not survive and their data were not included. Of 34 patients included, median age was 6.5 months, median body weight was 6050 g, and 16 (47%) were female. According to the Mann-Whitney U test, there were no differences between the two groups concerning demographic and intraoperative data, postoperative chemical data. C1q concentration was only significant lower in patients with C1-inh non-treated group than in patients with C1-inh treated group. But, the consumption of C1q, C3, C4, CH 50 , and C1-inh in patients with C1-inhibitor non-treated group was observed early postoperatively. There is a significant difference in the values before and after C1-inh treatment between the two groups. The lower value in the C1-inh-treated group is explained by the activation of the classical pathway through the replenishment of complements by C1-inh treatment. This study proposes the administration of C1-inh is an effective therapy to reduce the activation and improve the clinical capillary leak syndrome.

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Section: Discussionmentioning

confidence: 99%

C1 esterase inhibitor in pediatric cardiac surgery with cardiopulmonary bypass plays a vital role in activation of the complement system

et al. 2019

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“…Le SFCS est une complication postopératoire grave des chirurgies cardiaques sous circulation extracorporelle (ou bypass cardiopulmonaire), avec une incidence de 4 à 37 % et une mortalité élevée [98,99]. Ce tableau, survenant en période postopératoire, serait lié à l'inflammation systémique engendrée par la CEC : le contact du sang avec les matériaux du circuit serait à l'origine d'une activation du complément, donnant lieu à une inflammation systémique (une augmentation de l'IL-8 et de l'IL-6 circulantes a été constatée après CEC) [98,100,101].…”

Section: Les Sfcs Post-traumatiques Et Postopératoiresunclassified

“…Ce tableau, survenant en période postopératoire, serait lié à l'inflammation systémique engendrée par la CEC : le contact du sang avec les matériaux du circuit serait à l'origine d'une activation du complément, donnant lieu à une inflammation systémique (une augmentation de l'IL-8 et de l'IL-6 circulantes a été constatée après CEC) [98,100,101].…”

Section: Les Sfcs Post-traumatiques Et Postopératoiresunclassified

Syndrome de fuite capillaire idiopathique et formes secondaires : une revue systématique de la littérature

Duron

Delestre

Amoura

et al. 2015

La Revue de Médecine Interne

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“…Even though studies in adults undergoing "off pump" CABG reported some degree of inflammatory response [18] , CPB is most often considered the main cause of inflammation. Predominately, CBP-associated systemic inflammatory response syndrome (SIRS) is triggered primarily by direct contact of blood with the artificial surface of the bypass circuit and mechanical shear [19,20] . Also, blood product transfusion leads directly to systemic inflammation [21] .…”

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confidence: 99%

Procalcitonin and Interleukin-6 Levels: Are They Useful Biomarkers in Cardiac Surgery Patients?

Clementi

Brocca²,

Virzì³

et al. 2017

Blood Purif

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Background/Aim: Cardiac surgery-associated acute kidney injury is an independent predictor of chronic renal disease and mortality. The scope of this study was to determine the utility of procalcitonin (PCT) and plasma interleukin-6 (IL-6) levels in predicting renal outcome and mortality in these patients. Methods: PCT and plasma IL-6 levels of 122 cardiac surgery patients were measured at 48 h after the surgical procedure. Primary endpoints were adverse renal outcome and mortality. Secondary endpoints were length of stay, bleeding, and number of transfusions. Results: PCT was found to be a better predictor of adverse renal outcome than IL-6. IL-6 seemed to be a better predictor of both 30-day and overall mortality than PCT. Neither PCT nor IL-6 levels were found to be good predictors of intensive care unit stay and bleeding. Conclusion: PCT may be considered a good predictor of adverse renal outcome in cardiac surgery patients, whereas IL-6 seems to possess a good predictive value for mortality in this population of patients.

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Early prediction of capillary leak syndrome in infants after cardiopulmonary bypass†

Abstract: Diagnostic microdialysis can detect local inflammation and may predict the development of CLS early before severe clinical signs appear.

Cited by 27 publications

References 23 publications

C1 esterase inhibitor in pediatric cardiac surgery with cardiopulmonary bypass plays a vital role in activation of the complement system

C1 esterase inhibitor in pediatric cardiac surgery with cardiopulmonary bypass plays a vital role in activation of the complement system

Syndrome de fuite capillaire idiopathique et formes secondaires : une revue systématique de la littérature

Procalcitonin and Interleukin-6 Levels: Are They Useful Biomarkers in Cardiac Surgery Patients?

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