Neutrophil adhesion molecule expression and serum concentration of soluble adhesion molecules during and after pediatric cardiovascular surgery with or without cardiopulmonary bypass.
BACKGROUND
Increased neutrophil activation by cardiopulmonary bypass (CPB) during cardiovascular surgery is thought to be responsible for postoperative complications. In children, the contribution of cardiovascular surgery alone to this response is not well-characterized.


METHODS
Children undergoing surgery with CPB (CPB group, n = 35) and without CPB (control, n = 22) were studied (age, 3-17 yr). Blood was drawn 24 h preoperatively before medication, after anesthesia, after connection to CPB, at reperfusion, 4 h to 2 days after surgery, at discharge, and months after surgery. Neutrophil antigen expression and serum concentration of adhesion molecules, interleukin 8, and C5a (fragment of C5 complement) were analyzed by flow cytometry and enzyme-linked immunosorbent assay, respectively.


RESULTS
With and without CPB, anesthesia and surgery induced decreased LFA-1 (CD11a-CD18), Mac-1 (CD11b-CD18), CD45, and CD54 (intercellular adhesion molecule 1) surface expression and sICAM-1 serum concentrations (all P < 0.001). sL-selectin serum concentration decreased with CPB (P < 0.001) but was not significantly altered in the control. In contrast, CD62L expression increased during CPB (P < 0.001). The time course of all analyzed markers was not significantly different between CPB and control, with the exception of sL-selectin (P = 0.017). One-day preoperative baseline values were reached days to months after surgery. Interleukin 8 and C5a serum concentrations increased after surgery in both the CPB group and the control group.


CONCLUSIONS
Pediatric cardiovascular surgery leads to reduced adhesiveness and activity of circulating neutrophils. This reduction is more pronounced and sustained with CPB. These data may be useful in the assessment of novel therapeutic strategies.
Hambsch
Jörg
J
Department of Pediatric Cardiology, Cardiac Center Leipzig, University of Leipzig, Leipzig, Germany.
Osmancik
Pavel
P
Bocsi
József
J
Schneider
Peter
P
Tárnok
Attila
A
D000293:Adolescent; D002315:Cardiopulmonary Bypass; D013504:Cardiovascular Surgical Procedures; D015815:Cell Adhesion Molecules / Q000096:biosynthesis* / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D015936:Complement C5a / Q000096:biosynthesis; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D016023:Integrins / Q000096:biosynthesis; D018799:Intercellular Adhesion Molecule-1 / Q000096:biosynthesis; D016209:Interleukin-8 / Q000096:biosynthesis; D007700:Kinetics; D017493:Leukocyte Common Antigens / Q000096:biosynthesis; D008297:Male; D009504:Neutrophils / Q000378:metabolism*; D019087:Selectins / Q000096:biosynthesis
D015815:Cell Adhesion Molecules; D016023:Integrins; D016209:Interleukin-8; D019087:Selectins; D018799:Intercellular Adhesion Molecule-1; D015936:Complement C5a; D017493:Leukocyte Common Antigens