Soluble P-selectin and the postoperative course following cardiopulmonary bypass in children.
BACKGROUND
Cytokine-inducible leucocyte-endothelial adhesion molecules were shown to affect the postoperative inflammatory response following cardiopulmonary bypass (CPB). Soluble P-selectin (sP-selectin) is one of these molecules. We investigated the correlation between plasma sP-selectin levels and the intra- and postoperative course in children undergoing CPB.


METHODS
Serial blood samples of 13 patients were collected preoperatively upon initiation of CPB and seven times postoperatively. Plasma was recovered immediately and frozen at - 70 degrees C until use. Circulating soluble selectin molecules were measured with a sandwich enzyme-linked immunoabsorbent assay technique.


RESULTS
The significant post-CPB changes in sP-selectins plasma levels were associated with patient characteristics, operative variables and postoperative course. sP-selectin levels correlated significantly with surgery time, aortic cross-clamping time and inotropic support, as well as with the postoperative Pediatric Risk of Mortality score, hypotension and tachycardia.


CONCLUSIONS
A relation between CPB-induced mediators and both early and late clinical effects is suggested. The up-regulation and expression of sP-selectin indicate neutrophil activation as a possible mechanism for the increase, and inhibiting it may reduce the inflammatory response associated with CPB.
Lotan
D
D
Department of Pediatric Intensive Care, The Chaim Sheba Medical Center, Tel-Hashomer 52621, Israel.
Prince
T
T
Dagan
O
O
Keller
N
N
Ben-Abraham
R
R
Weinbroum
A
A
Gaby
A
A
Augarten
A
A
Smolinski
A
A
Barzilay
Z
Z
Paret
G
G
D002315:Cardiopulmonary Bypass; D002648:Child; D002675:Child, Preschool; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007223:Infant; D007249:Inflammation / Q000473:pathology; D008297:Male; D019007:P-Selectin / Q000097:blood*; D011184:Postoperative Period; D016896:Treatment Outcome
D019007:P-Selectin