Plasma angiopoietin-2 levels increase in children following cardiopulmonary bypass.
OBJECTIVE
The aim was to investigate the effects of cardiopulmonary bypass (CPB) on plasma levels of the vascular growth factors, angiopoietin (angpt)-1, angpt-2, and vascular endothelial growth factor (VEGF).


METHODS
The design was a prospective, clinical investigation.


METHODS
The setting was a 12-bed pediatric cardiac intensive care unit of a tertiary children's medical center.


METHODS
The patients were 48 children (median age, 5 months) undergoing surgical correction or palliation of congenital heart disease who were prospectively enrolled following informed consent.


METHODS
There were no interventions in this study.


RESULTS
Plasma samples were obtained at baseline and at 0, 6, and 24 h following CPB. Angpt-1, angpt-2, and VEGF levels were measured via commercial ELISA. Angpt-2 levels increased by 6 h (0.95, IQR 0.43-2.08 ng mL(-1) vs. 4.62, IQR 1.16-6.93 ng mL(-1), P < 0.05) and remained significantly elevated at 24 h after CPB (1.85, IQR 0.70-2.76 ng mL(-1); P < 0.05). Angpt-1 levels remained unchanged immediately after CPB, but were significantly decreased at 24 h after CPB (0.64, IQR 0.40-1.62 ng mL(-1) vs. 1.99, IQR 1.23-2.63 ng mL(-1), P < 0.05). Angpt-2 levels correlated significantly with cardiac intensive care unit (CICU) length of stay (LOS) and were an independent predictor for CICU LOS on subsequent multivariate analysis.


CONCLUSIONS
Angpt-2 appears to be an important biomarker of adverse outcome following CPB in children.
Giuliano
John S
JS
Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, USA.
Lahni
Patrick M
PM
Bigham
Michael T
MT
Manning
Peter B
PB
Nelson
David P
DP
Wong
Hector R
HR
Wheeler
Derek S
DS
D000293:Adolescent; D042683:Angiopoietin-1 / Q000097:blood; D042702:Angiopoietin-2 / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000097:blood / Q000601:surgery*; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D007902:Length of Stay; D008297:Male; D042461:Vascular Endothelial Growth Factor A / Q000097:blood
D042683:Angiopoietin-1; D042702:Angiopoietin-2; D015415:Biomarkers; D042461:Vascular Endothelial Growth Factor A