title: Inflammatory response of neutrophil granulocytes and monocytes after cardiopulmonary bypass in pediatric cardiac surgery.
abstract: OBJECTIVE
  To determine whether the activation state of polymorphonuclear neutrophils (PMNs) and monocytes contributes to the inflammatory response after cardiopulmonary bypass (CPB) in pediatric cardiac surgery.
  
  
  METHODS
  Observational prospective clinical study.
  
  
  METHODS
  Pediatric intensive care unit of a university hospital.
  
  
  METHODS
  Twenty pediatric patients before and after open heart surgery with CPB.
  
  
  METHODS
  Cell counts of circulating PMNs and monocytes as well as phenotypic and functional analysis of these cells, and plasma levels of myeloperoxidase.
  
  
  RESULTS
  Levels of myeloperoxidase (a marker of PMN degranulation) were significantly elevated after CPB (2.9+/-1.6 ng/ml before CPB versus 13.7+/-6.5 ng/ml after CPB, p=0.0001). However, PMN function, as measured by surface expression of CD11b/CD18 and phagocytic respiratory burst, was reduced. In contrast, the phagocytic respiratory burst of circulating monocytes was increased in some patients and there was a correlation with the increase of monocyte cell count after CPB (r=0.63, p=0.015).
  
  
  CONCLUSIONS
  After the end of CPB, there was an ongoing inflammatory process. In particular, there was an activation of monocytes after the end of CPB.
authors.affiliation: Department of Pediatric Intensive Care & Neonatology, University Children's Hospital, Steinwiesstrasse 75, 8032 Zurich, Switzerland. peter.gessler@kispi.unizh.ch
authors.forename: Peter
authors.initials: P
authors.lastname: Gessler
authors.forename: Juerg
authors.initials: J
authors.lastname: Pfenninger
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Pfammatter
authors.forename: Thierry
authors.initials: T
authors.lastname: Carrel
authors.forename: Clemens
authors.initials: C
authors.lastname: Dahinden
mesh_terms: D000293:Adolescent; D002097:C-Reactive Protein / Q000378:metabolism; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D002648:Child; D002675:Child, Preschool; D016207:Cytokines / Q000097:blood; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007223:Infant; D007249:Inflammation; D016018:Least-Squares Analysis; D008297:Male; D009000:Monocytes / Q000378:metabolism*; D009504:Neutrophils / Q000378:metabolism*; D009195:Peroxidase / Q000097:blood; D011446:Prospective Studies
chemical_list: D016207:Cytokines; D002097:C-Reactive Protein; D009195:Peroxidase