Back to Search Start Over

Does cardiac surgery in newborn infants compromise blood cell reactivity to endotoxin?

Authors :
Schumacher K
Korr S
Vazquez-Jimenez JF
von Bernuth G
Duchateau J
Seghaye MC
Source :
Critical care (London, England) [Crit Care] 2005 Oct 05; Vol. 9 (5), pp. R549-55. Date of Electronic Publication: 2005 Aug 09.
Publication Year :
2005

Abstract

Introduction: Neonatal cardiac surgery is associated with a systemic inflammatory reaction that might compromise the reactivity of blood cells against an inflammatory stimulus. Our prospective study was aimed at testing this hypothesis.<br />Methods: We investigated 17 newborn infants with transposition of the great arteries undergoing arterial switch operation. Ex vivo production of the pro-inflammatory cytokine tumor necrosis factor-alpha (TNF-alpha), of the regulator of the acute-phase response IL-6, and of the natural anti-inflammatory cytokine IL-10 were measured by enzyme-linked immunosorbent assay in the cell culture supernatant after whole blood stimulation by the endotoxin lipopolysaccharide before, 5 and 10 days after the operation. Results were analyzed with respect to postoperative morbidity.<br />Results: The ex vivo production of TNF-alpha and IL-6 was significantly decreased (P < 0.001 and P < 0.002, respectively), whereas ex vivo production of IL-10 tended to be lower 5 days after the operation in comparison with preoperative values (P < 0.1). Ex vivo production of all cytokines reached preoperative values 10 days after cardiac surgery. Preoperative ex vivo production of IL-6 was inversely correlated with the postoperative oxygenation index 4 hours and 24 hours after the operation (P < 0.02). In contrast, postoperative ex vivo production of cytokines did not correlate with postoperative morbidity.<br />Conclusion: Our results show that cardiac surgery in newborn infants is associated with a transient but significant decrease in the ex vivo production of the pro-inflammatory cytokines TNF-alpha and IL-6 together with a less pronounced decrease in IL-10 production. This might indicate a transient postoperative anti-inflammatory shift of the cytokine balance in this age group. Our results suggest that higher preoperative ex vivo production of IL-6 is associated with a higher risk for postoperative pulmonary dysfunction.

Details

Language :
English
ISSN :
1466-609X
Volume :
9
Issue :
5
Database :
MEDLINE
Journal :
Critical care (London, England)
Publication Type :
Academic Journal
Accession number :
16277717
Full Text :
https://doi.org/10.1186/cc3794