Plasma-soluble E-selectin after cardiopulmonary bypass in children: is it a marker of the postoperative course?
OBJECTIVE
To investigate the relationship and possible role of soluble adhesion molecule E-selectin in the postoperative course in children undergoing cardiopulmonary bypass (CPB).


METHODS
Prospective cohort study.


METHODS
Pediatric intensive care unit of a university hospital.


METHODS
Thirteen children who were candidates for cardiac surgery.


METHODS
None.


RESULTS
Serial blood samples of 13 CPB patients were collected from the arterial catheter or from the bypass circuits preoperatively; on initiation of CPB; on termination of CPB; and 1, 2, 4, 8, 12, 18, 24, and 48 hours postoperatively. Plasma was recovered immediately, aliquoted, and frozen at -70 degrees C until use. Circulating soluble selectin molecules were measured with a sandwich enzyme-linked immunosorbent assay technique. There were significant changes in plasma levels of soluble E-selectins in patients after CPB, and these levels were associated with patient characteristics, operative variables, and postoperative course. Soluble E-selectin correlated significantly with inotropic support and the use of anti-inflammatory drugs. There was a significant association between the development of postoperative sepsis and soluble E-selectin levels. No correlation was found between soluble E-selectins and duration of CPB, aortic cross-clamping, or hemodynamic variables, including heart rate and mean systemic arterial pressure.


CONCLUSIONS
These results suggest a relationship between CPB-induced mediators and early and late clinical effects. Although the mechanism for the increase of soluble E-selectin remains to be elucidated, the upregulation of soluble E-selectin indicates neutrophil activation, and its inhibition may represent a target for reducing the inflammatory response associated with CPB.
Paret
G
G
Department of Pediatric Intensive Care, Chaim Sheba Medical Center, Tel Hashomer, Israel.
Prince
T
T
Keller
N
N
Dagan
O
O
Sasson
Y
Y
Barzilai
A
A
Guthmann
D
D
Barzilay
Z
Z
D002315:Cardiopulmonary Bypass; D002675:Child, Preschool; D015331:Cohort Studies; D019040:E-Selectin / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000097:blood; D011379:Prognosis; D011446:Prospective Studies; D018805:Sepsis / Q000097:blood / Q000209:etiology
D019040:E-Selectin