Inflammatory response of neutrophil granulocytes and monocytes after cardiopulmonary bypass in pediatric cardiac surgery.
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.
Gessler
Peter
P
Department of Pediatric Intensive Care & Neonatology, University Children's Hospital, Steinwiesstrasse 75, 8032 Zurich, Switzerland. peter.gessler@kispi.unizh.ch
Pfenninger
Juerg
J
Pfammatter
Jean-Pierre
JP
Carrel
Thierry
T
Dahinden
Clemens
C
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
D016207:Cytokines; D002097:C-Reactive Protein; D009195:Peroxidase