Immunodepression after CPB: Cytokine dynamics and clinics after pediatric cardiac surgery – A prospective trial

Justus, G; Walker, Christoph; Rosenthal, Lisa-Maria; Berger, Felix; Miera, Oliver; Schmitt, Katharina

doi:10.1016/j.cyto.2017.03.017

Cited by 22 publications

(20 citation statements)

References 55 publications

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“…Besides CIRP production, inflammatory cytokines (e.g., IL-6 and IL-10) exhibit a similar variation tendency after CPB, as described previously [22,23]. Multiple linear regression analysis indicated that the length of CPB time and IL-6 level contribute to CIRP production.…”

Section: Discussionsupporting

confidence: 81%

Plasma Cold-Inducible RNA-Binding Protein Predicts Lung Dysfunction After Cardiovascular Surgery Following Cardiopulmonary Bypass: A Prospective Observational Study

Xia

Jiang

et al. 2019

Med Sci Monit

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Background Cold-inducible RNA-binding protein (CIRP) has been identified as an inflammatory mediator that exerts its function in inflammatory diseases. However, the roles of CIRP in patients who received cardiovascular surgery necessitating cardiopulmonary bypass (CPB) are still unknown. The aim of this study was to examine CIRP levels and attempt to evaluate whether CIRP could serve as a predictor for lung dysfunction after cardiovascular surgery. Material/Methods Plasma CIRP levels were detected by ELISA in 31 patients who received cardiovascular surgery at different time points. Selective inflammatory cytokines (TNF-α, IL-6, IL-10, and TLR4) and mediators (Ang II, PAI-1, and soluble E-selectin) were also detected. Selective laboratory and clinical parameters were recorded at scheduled time points. Results Compared with pre-operation levels, CIRP levels significantly increased 6 h after cardiovascular surgery with CPB. Multiple linear regression analysis showed that the length of CPB time contributed to CIRP production ( P =0.013). Furthermore, CIRP was associated with Ang II (r=0.438, P =0.016), PAI-1 (r=0.485, P =0.006), and soluble E-selectin (r=0.470, P =0.008), which partly reflected lung injuries. Multiple linear regression analysis showed that CIRP levels were independently associated with PaO 2 /FiO 2 ratios ( P =0.021). Conclusions The length of CPB time contributed to the upregulation of CIRP in patients who received cardiovascular surgery with CPB. CIRP levels could serve as a biomarker to predict the onset of lung injury induced by cardiovascular surgery.

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Section: Discussionsupporting

confidence: 81%

Plasma Cold-Inducible RNA-Binding Protein Predicts Lung Dysfunction After Cardiovascular Surgery Following Cardiopulmonary Bypass: A Prospective Observational Study

Xia

Jiang

et al. 2019

Med Sci Monit

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“…Isolation of leukocyte is affected by the duration of the aortic and CPB mutual clamping. It is believed that this is one of the major causes of pulmonary damage after onpump surgery [49][50][51]. Several studies have been carried out to illustrate the effects of the pump on PC.…”

Section: Cardiopulmonary Bypass Pumpmentioning

confidence: 99%

Pulmonary complications following cardiac surgery

Mali¹,

Haghaninejad²

2019

Arch Med Sci Atheroscler Dis

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Coronary heart disease is a common diseases of atherosclerosis. Despite the development of noninvasive therapies and the advancement of pharmacological methods and extensive drug regimens, coronary artery bypass grafting surgery is still the ultimate treatment option in many patients. Among the various complications following open heart surgery, one of the common difficulties is pulmonary complications associated with subsequent morbidity and mortality, which should be studied according to preoperative, perioperative, and postoperative factors. Preoperative factors include genetics, age, family history of pulmonary disease, smoking, coexisting disease, etc. Perioperative factors include surgical procedures like sternotomy incision, cardioplegia, and internal mammary artery harvesting; anaesthesia procedure effects like pulmonary collapse, maintenance drugs and morphine administration; and cardiopulmonary bypass pump by systemic inflammatory response syndromes. And finally, postoperative factors, especially mediastinitis and the role of nursing in the intensive care unit. Pulmonary complications after cardiac surgery include atelectasis, pleural effusions, pneumonia, pulmonary oedema, cardiogenic pulmonary oedema, acute respiratory distress syndrome, pulmonary embolism, phrenic nerve injury, pneumothorax, sternal wound infection, and mediastinitis, with different outbreaks in patients reported. Although the preoperative, perioperative, and postoperative factors play an important role in the occurrence of these complications, the preoperative factors, as factors that can be adjusted, should be considered more than the others and explained to the patient, and the preoperative patient's assessment should be noted. Also, postoperative care with the goal of reducing infections and pulmonary complications should be addressed by the nursing team.

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“…выше). Кроме того, от-сутствие заметного увеличения содержания IL-4, сопоставимого с повышением плазменной концентрации провоспалительных цитокинов, у пациентов данной группы после коронарного шунтирования может отражать также дефицит клеток-продуцентов цитокина (Тh2) и (или) их неспособность отвечать на развитие СВР (Т-кле-точная анергия), что формирует иммунную не-достаточность [2].…”

Section: показательunclassified

“…При ýтом использование ИК рассматривается в качестве основной причины раз-вития системной воспалительной реакции (СВР) у кардиохирургических пациентов в послеопера-ционном периоде. Подобный ответ организма на перфузию вызван контактом крови с чужеродны-ми поверхностями ýкстракорпорального контура и активацией системы комплемента, травматизацией форменных ýлементов крови в турбулентном по-токе, ишемией и реперфузией тканей, гиперокси-ей и гипотермией, транслокацией ýндотоксинов в кровь через ишемизированную стенку кишечника на фоне централизации кровотока, а также повре-ждением тканей операционного поля [1][2][3][4].…”

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“…Наряду с ýтим анализ современной литературы обнаружил разногласие сведений о характере изменений цитокинопродукции после коронарного шунтирования. Сообщается как о повышении концентрации интерлейкина (IL)-1β, IL-6, IL-8 и фактора некроза опухоли (TNF) α в раннем послеоперационном периоде, так и о сни-жении содержания указанных цитокинов в крови [1,2,4,9]. Показана также (но не объяснена) за-висимость кинетики TNF-α от его дооперацион-ной концентрации в крови: при исходно высоких показателях уровня TNF-α наблюдается отрица-тельная динамика цитокина, при нормальном со-держании до операции -положительная [9].…”

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Cytokines as inducers of postperfusion systemic inflammatory reaction in cardiosurgical patients with different duration of coronary pathology

Chumakova¹,

Уразова²,

Шипулин³

et al. 2017

Bûll. sib. med.

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Immunodepression after CPB: Cytokine dynamics and clinics after pediatric cardiac surgery – A prospective trial

Cited by 22 publications

References 55 publications

Plasma Cold-Inducible RNA-Binding Protein Predicts Lung Dysfunction After Cardiovascular Surgery Following Cardiopulmonary Bypass: A Prospective Observational Study

Plasma Cold-Inducible RNA-Binding Protein Predicts Lung Dysfunction After Cardiovascular Surgery Following Cardiopulmonary Bypass: A Prospective Observational Study

Pulmonary complications following cardiac surgery

Cytokines as inducers of postperfusion systemic inflammatory reaction in cardiosurgical patients with different duration of coronary pathology

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