Interleukin-10, T-lymphocytes, and cardiac output in children after ventricular septal defect repair: a pilot study.
OBJECTIVE
To evaluate the acute inflammatory response and cardiac output in children after surgery for ventricular septal defect.


METHODS
Prospective, observational study in a level III multidisciplinary neonatal and pediatric intensive care unit.


METHODS
Ten children undergoing open-heart surgery for ventricular septal defect.


METHODS
All children received methylprednisolone (30 mg/kg) in cardiopulmonary bypass (CPB) prime.


RESULTS
Before and after cardiopulmonary bypass, plasma interleukin-10 and tumor necrosis factor alpha were measured by enzyme-linked immunosorbent assay, and lymphocyte subsets in peripheral blood by flow cytometry. Relative values (post-/pre-CPB) of interleukin-10 and tumor necrosis factor alpha were calculated. The cardiac index (CI) was measured continuously beat-to-beat by a pulse contour analysis (PiCCO). Children above the cutoff value (median cardiac index value 3.0 l min(-1) m(-2)) were designated as the normal CI group and those below this value as the low CI group. In the normal CI group the relative values of interleukin-10 remained almost seven times higher than pre-CPB values at 24 h while in the low CI group they decreased almost to pre-CPB values. Furthermore, the normal CI group, but not the low CI group, exhibited more than threefold decrease in T-lymphocytes (lymphocyte T-cells, T-helper cells, and cytotoxic T-cells) 24 h after CPB.


CONCLUSIONS
Children operated on for ventricular septal defect developed either a normal or low CI. The higher relative values of interleukin-10 and lower counts of lymphocyte T-cells, T-helper and cytotoxic T-cells differentiated the normal CI group from the low CI group at 24 h after cardiopulmonary bypass.
Department of Pediatric Surgery and Intensive Care, University Medical Center Ljubljana, Zaloska 7, 1525, Ljubljana, Slovenia. stefan.grosek@mf.uni-lj.si
Stefan
S
Grosek
Janez
J
Primozic
Alojz
A
Ihan
Branka
B
Wraber
Tone
T
Gabrijelcic
Miro
M
Kosin
D002302:Cardiac Output / Q000502:physiology*; D002315:Cardiopulmonary Bypass; D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000601:surgery*; D006801:Humans; D007223:Infant; D016753:Interleukin-10 / Q000032:analysis* / Q000097:blood; D008297:Male; D010865:Pilot Projects; D011446:Prospective Studies; D017524:Slovenia; D018746:Systemic Inflammatory Response Syndrome; D013601:T-Lymphocytes
D016753:Interleukin-10