Tumor necrosis factor and clinical and metabolic courses after cardiac surgery in children

Abstract

Tumor necrosis factor released into the circulation during and after pediatric cardiac surgery under cardiopulmonary bypass may be related to the hemodynamic and acid-base changes observed after cardiac surgery. Elucidation of the relationship between tumor necrosis factor and patient outcome in high-risk patients awaits further studies.

Chemokines and the inflammatory response following cardiopulmonary bypass – a new target for therapeutic intervention? – a review

“…This process has been previously studied in great detail, but its immunoregulatory characteristics remain uncertain. Early reports had focused on the changes in serum pro‐inflammatory cytokine activity during and after CPB in both children and adults, alterations that appeared similar to those occurring in sepsis (2,3,5,6). These pro‐inflammatory mediators include the tumour necrosis factor (TNF), interleukin‐1 (IL‐1), interleukin‐6 (IL‐6), and interleukin‐8 (IL‐8) which are responsible for the complex interactions between various types of leucocytes.…”

“…It is currently accepted that inflammatory cytokines together with endothelial activation and endothelial–leucocyte interactions play an important role in the induction of systemic inflammatory response (3,5,8,9) (Table 1). The resultant inflammatory response causes increased permeability of membranes and total body water, leading to respiratory distress and severe multiorgan failure.…”

Serum TNF‐α levels in children with congenital heart disease undergoing cardiopulmonary bypass: A cohort study in China and a meta‐analysis of the published literature

“…A total of 12 studies met our inclusion criteria for this meta‐analysis . These 12 included studies were composed of 190 CHD patients treated with CPB surgery.…”

“…A total of 12 studies met our inclusion criteria for this metaanalysis. 21,24,[32][33][34][35][36][37][38][39][40][41] These 12 included studies were composed of 190 CHD patients treated with CPB surgery. The heterogeneity was significantly observed (T1 vs T2: I 2 =92.4%, P h <.001; T2 vs T3:…”

Immediate post-operative care following cardiac surgery

“…O tratamento inclui o uso de corticosteróides. -Síndrome da resposta inflamatória sistêmica 24 : como referida anteriormente, há liberação de fator de necrose tumoral e outras citocinas na circulação. Com a evolução, pode levar à disfunção de múltiplos órgãos e sistemas.…”