The influence of bypass temperature on the systemic inflammatory response and organ injury after pediatric open surgery: A randomized trial

Stöcker, Christian; Shekerdemian, Lara; Horton, Stephen; Lee, Katherine J.; Eyres, R. L.; d’Udekem, Yves

doi:10.1016/j.jtcvs.2011.01.059

Cited by 31 publications

(39 citation statements)

References 19 publications

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“…CHDs are the key factors of malnutrition and growth disorders. Therefore, malnutrition and growth retardation in CHD patients are common 16. The reason of malnutrition in these patients is several factors that decrease or increase the magnitude of required energy 17.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of serum level of tumor necrosis factor-alpha and interleukin-6 in patients with congenital heart disease

et al. 2016

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Background:The objective of the study is to assess the levels of tumor necrosis factor-alpha (TNF-α) and interleukin-10 (IL-10) in patients with congenital heart diseases (CHDs) and control.Patients and Methods:In this case-control study, sixty patients with CHD with ages of 1 month to 15 years and thirty healthy subjects were assessed. All objects measured in height, weight, age, sex, and body mass index (BMI). Patients diagnosed by echocardiography and patients’ blood samples were 3 ml and taken in the catheterization laboratory through catheter and kept for 60 min at a room with normal temperature and separated serum has been held. All samples in compliance with the cold chain carried out to biochemistry laboratory and finally the levels of serum TNF-α and IL-6 were measured by Elisa Kit. Data were analyzed with Statistical Package for Social Sciences version 20. Nonparametric tests by considering 95% confidence interval were applied.Results:The mean of age in cyanotic patients was 4.28 ΁ 3.44 years, a cyanotic was 3.12 ΁ 3.87 years and for the control group was 3.30 ΁ 3.61 years. Comparison of TNF-α (Mann-Whitney U-test = 56.62, P < 0.001), IL-6 (Mann-Whitney U-test = 313.5, P < 0.001), right ventricular (RV) pressure (Mann-Whitney U-test = 27, P < 0.001), pulmonary artery (PA) pressure (Mann-Whitney U-test = 618, P = 0.015), and BMI (Mann-Whitney U-test = 214.5, P < 0.001) in the case and control groups resulted in significant differences. To compare TNF-α (Chi-square = 57.82, P < 0.001), IL-6 (Chi-square = 54.70, P < 0.001), RV pressure (Chi-square = 71.35, P < 0.001), PA pressure (Chi-square = 5.92, P = 00.052), oxygen saturation (Chi-square = 74.70, P < 0.001), and BMI (Chi-square = 34.90, P < 0.001) in cyanotic, acyanotic, and control groups resulted that there were significant differences between these three groups except PA pressure.Conclusion:The findings of this study showed that in patients with CHD, serum levels of TNF-α increased but IL-6 not changed when compared to control and this increase in necrosis tumoral factor-α would be related with hypoxia and remarkable left to right shunt and caused growth retardation in these patients.

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Section: Discussionmentioning

confidence: 99%

Evaluation of serum level of tumor necrosis factor-alpha and interleukin-6 in patients with congenital heart disease

et al. 2016

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“…Stocker et al3) studied the influence of CPB temperature of pediatric patients. Mild hypothermia group showed similar clinical outcomes and inflammatory markers with hypothermia group.…”

Section: Discussionmentioning

confidence: 99%

“…Among them, 212 patients were VSD patients. The lowest bypass temperature of hypothermia (26℃-29℃) and near-normothermia (34℃-36℃) were selected3) (Fig. 1).…”

Section: Methodsmentioning

confidence: 99%

“…As a laboratory parameter for inflammatory reaction, white blood cell (WBC) count and C-reactive protein (CRP) of preoperative and postoperative day 1, 2, and 4 were serially reviewed3,4).…”

Section: Methodsmentioning

confidence: 99%

“…The main aim of cooling the body is to protect major organs from ischemic injury by reducing the oxygen consumption and whole body inflammatory response to CPB2,3).…”

Section: Introductionmentioning

confidence: 99%

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Outcome of inflammatory response after normothermia during cardiopulmonary bypass surgery in infants with isolated ventricular septal defect

Kim

Lee

et al. 2014

Korean J Pediatr

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PurposeA recent study analyzing several cytokines reported that long cardiopulmonary bypass (CPB) time and long aortic cross clamp (ACC) time were accompanied by enhanced postoperative inflammation, which contrasted with the modest influence of the degree of hypothermia. In this present study, we aimed to examine the effect of CPB temperature on the clinical outcome in infants undergoing repair of isolated ventricular septal defect (VSD).MethodsOf the 212 infants with isolated VSD who underwent open heart surgery (OHS) between January 2001 and December 2010, 43 infants were enrolled. They were classified into 2 groups: group 1, infants undergoing hypothermic CPB (26℃-28℃; n=19) and group 2, infants undergoing near-normothermic CPB (34℃-36℃; n=24).ResultsThe age at the time of the OHS, and number of infants aged<3 months showed no significant differences between the groups. The CPB time and ACC time in group 1 were longer than those in group 2 (88 minutes vs. 59 minutes, P=0.002, and 54 minutes vs. 37 minutes, P=0.006 respectively). The duration of postoperative mechanical ventilation was 1.6 days in group 1 and 1.8 days in group 2. None of the infants showed postoperative neurological and developmental abnormalities. Moreover, no postoperative differences in the white blood cell count and C-reactive protein levels were noted between two groups.ConclusionThis study revealed that hypothermic and near-normothermic CPB were associated with similar clinical outcomes and inflammatory reactions in neonates and infants treated for simple congenital heart disease.

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Management of Pediatric Cardiopulmonary Bypass

Andersen¹,

Meza²,

Turek³

2023

Pediatric Cardiac Surgery

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The influence of bypass temperature on the systemic inflammatory response and organ injury after pediatric open surgery: A randomized trial

Abstract: There is no evidence that the systemic inflammatory response syndrome and organ injury after pediatric open surgery are influenced by bypass temperature. The routine use of hypothermic bypass may not be warranted in the pediatric population.

Cited by 31 publications

References 19 publications

Evaluation of serum level of tumor necrosis factor-alpha and interleukin-6 in patients with congenital heart disease

Evaluation of serum level of tumor necrosis factor-alpha and interleukin-6 in patients with congenital heart disease

Outcome of inflammatory response after normothermia during cardiopulmonary bypass surgery in infants with isolated ventricular septal defect

Management of Pediatric Cardiopulmonary Bypass

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