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The Journal of Cardiovascular Surgery 1999 December;40(6):803-9

Copyright © 2000 EDIZIONI MINERVA MEDICA

lingua: Inglese

IL-8, IL-6 and ICAM-1 in serum of paediatric patients undergoing cardiopulmonary bypass with and without cardiocirculatory arrest

Antonelli M., Testa G.*, Tratapepe L., D’Errico R. R., Costa D.*, Giovannelli L.**, Riccioni L., Gasparetto A., Catena G.*

From the Department of Anaesthesia and Intensive Care, University “La Sapienza”, Rome, Italy *Medical and Surgical Department of Pediatric Cardiology and **Transfusion Center ”Bambino Gesù“ Hospital, Rome, Italy


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Back­ground. The aim of the ­present ­study was to eval­uate the ­systemic inflam­ma­tory ­response to CPB in paed­i­atric ­patients under­going sur­gical cor­rec­tion of con­gen­ital ­heart dis­eases.
­Methods. Experi­mental ­design: com­par­a­tive inves­ti­ga­tion. Set­ting: paed­i­atric car­di­ology hos­pital. Inter­ven­tion: ­ICAM-1, IL-8, and IL-6 pro­duc­tion ­were ana­lysed ­before and ­during CPB, and ­after sur­gery in 9 paed­i­atric ­patients, sub­mitted to car­di­o­cir­cu­la­tory ­arrest (­Group A); and in 11 ­without car­di­o­cir­cu­la­tory ­arrest (­Group B). Meas­ures: ­ICAM-1, IL-8, and IL-6 pro­duc­tion ­were ana­lysed ­from arte­rial sam­ples ­before and ­during CPB, and ­after sur­gery.
­Results. In ­group A vs ­group B a sig­nif­i­cant ­increase of IL-8 was ­detected ­during (297±250 vs 11±19 pg·ml-1, p<0.001) and ­after (100±230 vs n.d. pg·ml-1) sur­gery and was cor­re­lated ­with the dura­tion of oper­a­tion (r=0.759; p=0.0001) and ­clamping ­time (r=0.738; p<0.05). ­After sur­gery in ­group A, IL-6 ­levels (35±43 pg·ml) ­were ­higher ­than ­those in ­group B (2±5 pg·ml), and a ­good cor­re­la­tion was ­observed ­between IL-6 and dura­tion of ­aortic ­clamping (r=0.714; p=0.048), car­diac ­arrest, (r=0.714; p=0.048), and ­length of sur­gery (r=0.867; p=0.04).
Con­clu­sions. In chil­dren who under­went CPB ­with car­di­o­cir­cu­la­tory ­arrest cyto­kine pro­duc­tion ­seems ­related to dura­tion of oper­a­tion and ampli­fied by ­ischemia-reper­fu­sion phe­nomena.

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