title: Prolonged granulocyte activation, as well as hypoxanthine and free radical production after open heart surgery in children.
abstract: OBJECTIVE
  To investigate granulocyte activation, as well as hypoxanthine and free radical production in children during the first day after cardiopulmonary bypass.
  
  
  METHODS
  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.
  
  
  METHODS
  Operative and intensive care units, Children's Hospital, University of Helsinki, Finland.
  
  
  METHODS
  Seven consecutive patients undergoing elective correction of a ventricular septal defect and six patients undergoing extracardiac surgery for ligation of a patent ductus arteriosus or repair a coarctation of the aorta.
  
  
  RESULTS
  Plasma concentrations of myeloperoxidase (140-334 micrograms/l preoperatively, 460-1692 micrograms/l at 0.2 h after declamping, 471-1386 micrograms/l at 0.5 h after declamping) and lactoferrin (77-258 micrograms/l preoperatively, 533-1783 at 0.2 h, 404-1482 micrograms/l at 0.5 h) as markers of granulocyte activation, and hypoxanthine (0-5.7 mumol/l preoperatively, 4.3-17.0 mumol/l at 0.2 h, 6.5-17.9 mumol/l at 0.5 h) increased in a biphasic manner at 0.2-0.5 h and 6-10 h postoperatively (all p < 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 < 0.005).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Children's Hospital, University of Helsinki, Finland.
authors.forename: E J
authors.initials: EJ
authors.lastname: Pesonen
authors.forename: R
authors.initials: R
authors.lastname: Korpela
authors.forename: M
authors.initials: M
authors.lastname: Leijala
authors.forename: H
authors.initials: H
authors.lastname: Sairanen
authors.forename: O M
authors.initials: OM
authors.lastname: Pitkänen
authors.forename: K O
authors.initials: KO
authors.lastname: Raivio
authors.forename: P
authors.initials: P
authors.lastname: Venge
authors.forename: S
authors.initials: S
authors.lastname: Andersson
mesh_terms: D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D002675:Child, Preschool; D005260:Female; D005609:Free Radicals / Q000097:blood*; D006098:Granulocytes / Q000276:immunology*; D006801:Humans; D019271:Hypoxanthine / Q000097:blood*; D007223:Infant; D007781:Lactoferrin / Q000097:blood; D015227:Lipid Peroxidation; D008297:Male; D015428:Myocardial Reperfusion Injury / Q000097:blood* / Q000276:immunology*; D009195:Peroxidase / Q000097:blood*; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D005609:Free Radicals; D019271:Hypoxanthine; D009195:Peroxidase; D007781:Lactoferrin