Erschienen in:
01.05.2006 | Pediatric Brief Report
Interleukin-10, T-lymphocytes, and
cardiac output in children after ventricular septal defect repair: a pilot study
verfasst von:
Stefan Grosek, Janez Primozic, Alojz Ihan, Branka Wraber, Tone Gabrijelcic, Miro Kosin
Erschienen in:
Intensive Care Medicine
|
Ausgabe 5/2006
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Abstract
Objective
To evaluate the acute inflammatory response and cardiac output in children
after surgery for ventricular septal defect.
Design and setting
Prospective, observational study in a level III multidisciplinary neonatal
and pediatric intensive care unit.
Patients
Ten children undergoing open-heart surgery for ventricular septal defect.
Interventions
All children received methylprednisolone (30 mg/kg) in cardiopulmonary
bypass (CPB) prime.
Measurements and results
Before and after cardiopulmonary bypass, plasma interleukin-10 and tumor
necrosis factor α were measured by enzyme-linked immunosorbent
assay, and lymphocyte subsets in peripheral blood by flow cytometry.
Relative values (post-/pre-CPB) of interleukin-10 and tumor necrosis factor
α were calculated. The cardiac index (CI) was measured continuously
beat-to-beat by a pulse contour analysis (PiCCO). Children above the cutoff
value (median cardiac index value 3.0 l min– 1 m– 2) were
designated as the normal CI group and those below this value as the low CI
group. In the normal CI group the relative values of interleukin-10 remained
almost seven times higher than pre-CPB values at 24 h while in the low CI
group they decreased almost to pre-CPB values. Furthermore, the normal CI
group, but not the low CI group, exhibited more than threefold decrease in
T-lymphocytes (lymphocyte T-cells, T-helper cells, and cytotoxic T-cells)
24 h after CPB.
Conclusions
Children operated on for ventricular septal defect developed either a normal
or low CI. The higher relative values of interleukin-10 and lower counts of
lymphocyte T-cells, T-helper and cytotoxic T-cells differentiated the normal
CI group from the low CI group at 24 h after cardiopulmonary bypass.