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Cytokines and pediatric open heart surgery with cardiopulmonary bypass

Published online by Cambridge University Press:  01 July 2011

Marcus V. H. Carvalho
Affiliation:
Division of Cardiac Surgery, Federal University of Saão Paulo – Escola Paulista de Medicina, São Paulo, Brasil
Miguel A. Maluf
Affiliation:
Division of Cardiac Surgery, Federal University of Saão Paulo – Escola Paulista de Medicina, São Paulo, Brasil
Roberto Catani
Affiliation:
Division of Cardiac Surgery, Federal University of Saão Paulo – Escola Paulista de Medicina, São Paulo, Brasil
Carlos A. A. La Rotta
Affiliation:
Division of Cardiac Surgery, Federal University of Saão Paulo – Escola Paulista de Medicina, São Paulo, Brasil
Walter J. Gomes
Affiliation:
Division of Cardiac Surgery, Federal University of Saão Paulo – Escola Paulista de Medicina, São Paulo, Brasil
Reinaldo Salomão
Affiliation:
Division of Infectious Diseases, Federal University of São Paulo – Escola Paulista de Medicina, São Paulo, Brasil
Célia M. da Silva
Affiliation:
Division of Cardiology, Federal University of São Paulo – Escola Paulista de Medicina, São Paulo, Brasil
Antonio C.C. Carvalho
Affiliation:
Division of Cardiology, Federal University of São Paulo – Escola Paulista de Medicina, São Paulo, Brasil
João N. R. Branco*
Affiliation:
Division of Cardiac Surgery, Federal University of Saão Paulo – Escola Paulista de Medicina, São Paulo, Brasil
Enio Buffolo
Affiliation:
Division of Cardiac Surgery, Federal University of Saão Paulo – Escola Paulista de Medicina, São Paulo, Brasil
*
Correspondence to: Prof Dr J N R Branco, Disciplina de Cirurgia Cardiovascular, Federal University of S©o Paulo – Escola Paulista de Medicina, R. Napoleao de Barros, 715 – CEP 04024–002 – São Paulo / Brasil. Tel: 55 011 576 4055; Fax: 55 11 571 2719

Abstract

It is well known that, subsequent to cardiopulmonary bypass, and particularly in children, an inflammatory response within the body can often result in a characteristic syndrome. Recently, it has been suggested that this phenomenon is due to a systemic inflammatory response, with significant involvement of cytokines. With this in mind, we investigated the behavior of tumour necrosis factor-α and interleukin–6 during the operative and in the immediate postoperative period in a group of children submitted to open heart surgery. We investigated any possible relation between the levels of these cytokines in the serum and the length of cardiopulmonary bypass, with the serum levels of lactate, and with the extent of use of inotropic drugs in postoperative period. The cytokines were measured in samples withdrawn after induction of anesthesia, after 10 minutes of cardiopulmonary bypass, after re-establishment of circulation, and then 2 and 24 hours after the end of cardiopulmonary bypass. The levels of tumour necrosis factor-α and interleukin–6 increased between the beginning and at two hours of the end of cardiopulmonary bypass. There was no correlation between the levels of these cytokines in the serum and the length of cardiopulmonary bypass, although there was a positive relation between levels of interleukin–6 and lactate in samples withdrawn at two hours of the end of bypass, and the measured levels of the cytokines correlated with the extent of inotropic drugs employed in the postoperative period.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2001

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