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Prolonged gramulocyte activation, as well as hypoxanthine and free radical production after open heart surgery in children

  • Neonatal and Pediatric Intensive Care
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Abstract

Objective

To investigate granulocyte activation, as well as hypoxanthine and free radical production in children during the first day after cardiopulmonary bypass.Design: A prospective study of pediatric patients undergoing either cardiac surgery with a cardiopulmonary bypass or thoracotomy and extracardiac vascular surgery not requiring a cardiopulmonary bypass.

Setting

Operative and intensive care units, Children's Hospital, University of Helsinki, Finland.

Patients

Seven consecutive patients undergoing elective correaction of a ventricular septal defect and six patients undergoing extracardiac surgery for ligation of a patent ductus arteriousus or repair a coarctation of the aorta.

Measurements and main results

Plasma concentrations of myeloperoxidase (140–334 μg/l preoperatively, 460–1692 μg/l at 0.2 h after declamping, 471–1386 μg/l at 0.5 h after declamping) and lactoferrin (77–258 μg/l preoperatively, 533–1783 at 0.2 h 404–1482 μg/l at 0.5 h) as markers of granulocyte activation, and hypoxanthine (0–5.7 μmol/l preoperatively, 4.3–17.0 μmol/l at 0.2 h, 6.5–17.9 μmol/l at 0.5 h) increased in a biphasic manner at 0.2–0.5 h and 6–10 h postoperatively (allp<0.05). Expired ethane, as an index of free radical activity, increased at 10 h postoperatively (36–119 pmol/kg per min preoperatively, 72–152 pmol/kg per min,p<0.05).

Conclusion

Granulocyte activation, and hypoxanthine and free radical production occur at least 10 h after cardiopulmonary bypass. In children undergoing open heart surgery, attempts to reduce free radical activity should be extended to the postoperative period.

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Authors and Affiliations

  1. Children's Hospital, University of Helsinki, Stenbäckinkatu 11, SF-00290, Helsinki, Finland

    E. J. Pesonen, R. Korpela, M. Leijala, H. Sairanen, O. M. Pitkänen & K. O. Ravio

  2. Department of Clinical Chemistry, Akademiska Sjukhuset, Uppsala, Sweden

    P. Venge

  3. Department I and II of Obstetrics and Gynecology, University of Helsinki, Helsinki, Finland

    S. Andersson

Authors
  1. E. J. Pesonen
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  2. R. Korpela
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  3. M. Leijala
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  4. H. Sairanen
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  5. O. M. Pitkänen
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  6. K. O. Ravio
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  7. P. Venge
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  8. S. Andersson
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Additional information

This study was supported by the Foundation for Pediatric Research, Academy of Finland, and the Sigrid Jusélius Foundation

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Pesonen, E.J., Korpela, R., Leijala, M. et al. Prolonged gramulocyte activation, as well as hypoxanthine and free radical production after open heart surgery in children. Intensive Care Med 22, 500–506 (1996). https://doi.org/10.1007/BF01712176

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  • DOI: https://doi.org/10.1007/BF01712176

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