Inflammatory Response After Neonatal Cardiac Surgery and Its Relationship to Clinical Outcomes

Mahle, William T.; Matthews, Emilia; Kanter, Kirk R.; Kogon, Brian; Hamrick, Shannon E. G.; Strickland, Matthew

doi:10.1016/j.athoracsur.2013.10.069

Cited by 57 publications

(56 citation statements)

References 13 publications

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“…The role of IL-10 in the post-CPB inflammatory response remains unclear. Although often considered to have anti-inflammatory activity, plasma IL-10 concentrations are consistently elevated following CPB (27,28). This may reflect acute activation and dysregulation of all inflammatory pathways or alternate activity in this setting.…”

Section: Discussionmentioning

confidence: 94%

Systemic Inflammation Increases Energy Expenditure Following Pediatric Cardiopulmonary Bypass

Floh

Nakada

Rotta

et al. 2015

Pediatric Critical Care Medicine

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Section: Discussionmentioning

confidence: 94%

Systemic Inflammation Increases Energy Expenditure Following Pediatric Cardiopulmonary Bypass

Floh

Nakada

Rotta

et al. 2015

Pediatric Critical Care Medicine

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“…Most forms of complex CHD surgeries require cardiopulmonary bypass (CPB), which is known to incite an inflammatory response, particularly in newborns [9,14]. While the inflammatory response has been described in detail, it is not known whether specific inflammatory responses relate to the degree of WMI following newborn heart surgery with CPB.…”

Section: Introductionmentioning

confidence: 98%

White Matter Injury and the Inflammatory Response Following Neonatal Cardiac Surgery

et al. 2015

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White matter injury (WMI) is a known complication following neonatal heart surgery in term infants. In preterm infants, WMI has been associated with the degree of systemic inflammation. It is not known whether inflammation is an important mechanism of WMI as documented by magnetic resonance imaging (MRI) following neonatal heart surgery with cardiopulmonary bypass. Term neonates with congenital heart disease were enrolled in a prospective study with postoperative MRI. White matter injury was recorded by the number of T1 hyperintense foci with >5 foci consistent with significant WMI. Eleven candidate cytokine markers (INF-gamma, TNF-alpha, IL-1 beta, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12, and IL-13) were assayed preoperatively and daily for 5 days following surgery. Multiple clinical factors were recorded and correlated with WMI. Ninety-two subjects were enrolled in the study. The median age at surgery was 5 days (interquartile range 4-7 days). Compared with the presurgery level, there were statistically significant increases (p < 0.005) for 8 out of 11 inflammatory markers. In all, 64 postoperative MRIs were performed. No significant correlation was detected between WMI and clinical variables or inflammatory markers assessed immediately postoperative and on postoperative days 1 and 3, with exception of IL-1 beta on postoperative day 1. WMI correlates poorly with the systemic inflammatory response after congenital heart surgery and a number of herein measured clinical factors. WMI following neonatal heart surgery is a complex, still incompletely understood phenomenon that warrants continued investigation.

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“…Moreover, in experimental mice model, IL-6 lung effects are increased after an episode of AKI [46] , as IL-6 deficient and IL-6 antibody-treated mice have been found to develop reduced lung inflammation and capillary leak after AKI [47] . Additionally, persistent elevation of specific cytokines seems to be associated with a prolonged ICU length of stay [48] . In particular, IL-8 and IL-13 measured on postoperative day 3 after surgery with CPB were found to be the strongest predictor of prolonged ICU stay [48] .…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, persistent elevation of specific cytokines seems to be associated with a prolonged ICU length of stay [48] . In particular, IL-8 and IL-13 measured on postoperative day 3 after surgery with CPB were found to be the strongest predictor of prolonged ICU stay [48] . Conversely, in our study, neither PCT nor IL-6 was found to be a good predictor of length of stay.…”

Section: Discussionmentioning

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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Inflammatory Response After Neonatal Cardiac Surgery and Its Relationship to Clinical Outcomes

Cited by 57 publications

References 13 publications

Systemic Inflammation Increases Energy Expenditure Following Pediatric Cardiopulmonary Bypass

Systemic Inflammation Increases Energy Expenditure Following Pediatric Cardiopulmonary Bypass

White Matter Injury and the Inflammatory Response Following Neonatal Cardiac Surgery

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

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