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Does cardiac surgery in newborn infants compromise blood cell reactivity to endotoxin?
- 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.
- Subjects :
- Blood Cells immunology
C-Reactive Protein analysis
C-Reactive Protein biosynthesis
Humans
Infant, Newborn
Interleukin-10 analysis
Interleukin-6 analysis
Prospective Studies
Statistics, Nonparametric
Transposition of Great Vessels immunology
Transposition of Great Vessels surgery
Tumor Necrosis Factor-alpha analysis
Cardiac Surgical Procedures
Interleukin-10 biosynthesis
Interleukin-6 biosynthesis
Lipopolysaccharides immunology
Tumor Necrosis Factor-alpha biosynthesis
Subjects
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