title: Dexamethasone prophylaxis in pediatric open heart surgery is associated with increased blood long pentraxin PTX3: potential clinical implications.
abstract: Glucocorticoid administration before cardiopulmonary bypass (CPB) can reduce the systemic inflammatory response and improve clinical outcome. Long pentraxin PTX3 is a novel inflammatory parameter that could play a protective cardiovascular role by regulating inflammation. Twenty-nine children undergoing open heart surgery were enrolled in the study. Fourteen received dexamethasone (1st dose 1.5  mg/Kg i.v. or i.m. the evening before surgery; 2nd dose 1.5  mg/kg i.v. before starting bypass) and fifteen children served as control. Blood PTX3, short pentraxin C-reactive protein (CRP), interleukin-1 receptor II (IL-1RII), fibrinogen and partial thromboplastin time (PTT) were assayed at different times. PTX3 levels significantly increased during CPB in dexamethasone-treated (+D) and dexamethasone-untreated (-D) subjects, but were significantly higher in +D than -D patients. CRP levels significantly increased both in +D and -D patients in the postoperative days, with values significantly higher in -D than +D patients. Fibrinogen and PTT values were significantly higher in -D than +D patients in the 1st postoperative day. IL-1RII plasma levels increased in the postoperative period in both groups. Dexamethasone prophylaxis in pediatric patients undergoing CPB for cardiac surgery is associated with a significant increase of blood PTX3 that could contribute to decreasing inflammatory parameters and improving patient clinical outcome.
authors.affiliation: Division of Cardiovascular Surgery, G. Gaslini Institute, IRCCS, Largo G. Gaslini 5, 16148 Genoa, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Lerzo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Peri
authors.forename: Andrea
authors.initials: A
authors.lastname: Doni
authors.forename: Paola
authors.initials: P
authors.lastname: Bocca
authors.forename: Fabio
authors.initials: F
authors.lastname: Morandi
authors.forename: Angela
authors.initials: A
authors.lastname: Pistorio
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Carleo
authors.forename: Alberto
authors.initials: A
authors.lastname: Mantovani
authors.forename: Vito
authors.initials: V
authors.lastname: Pistoia
authors.forename: Ignazia
authors.initials: I
authors.lastname: Prigione
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D002097:C-Reactive Protein / Q000378:metabolism*; D002315:Cardiopulmonary Bypass; D003907:Dexamethasone / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007223:Infant; D007249:Inflammation / Q000378:metabolism / Q000517:prevention & control*; D018836:Inflammation Mediators / Q000097:blood; D008297:Male; D000683:Serum Amyloid P-Component / Q000378:metabolism*; D000099153:Pentraxins
chemical_list: D000893:Anti-Inflammatory Agents; D002097:C-Reactive Protein; D003907:Dexamethasone; D018836:Inflammation Mediators; D000683:Serum Amyloid P-Component; D000099153:Pentraxins