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Plasma levels of alarmin HNPs 1–3 associate with lung dysfunction after cardiac surgery in children

BACKGROUND: Early onset of lung injury is considerable common after cardiac surgery and is associated with increasing in morbidity and mortality, but current clinical predictors for the occurrence of this complication always have limited positive warning value. This study aimed to evaluate whether e...

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Autores principales: Liu, XiWang, Chen, QiXing, Luo, YuJia, Hu, YaoQin, Lai, DengMing, Zhang, XiaoLe, Zhang, XiangHong, Yu, JianGen, Fang, XiangMing, Shu, Qiang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5745992/
https://www.ncbi.nlm.nih.gov/pubmed/29282039
http://dx.doi.org/10.1186/s12890-017-0558-4
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author Liu, XiWang
Chen, QiXing
Luo, YuJia
Hu, YaoQin
Lai, DengMing
Zhang, XiaoLe
Zhang, XiangHong
Yu, JianGen
Fang, XiangMing
Shu, Qiang
author_facet Liu, XiWang
Chen, QiXing
Luo, YuJia
Hu, YaoQin
Lai, DengMing
Zhang, XiaoLe
Zhang, XiangHong
Yu, JianGen
Fang, XiangMing
Shu, Qiang
author_sort Liu, XiWang
collection PubMed
description BACKGROUND: Early onset of lung injury is considerable common after cardiac surgery and is associated with increasing in morbidity and mortality, but current clinical predictors for the occurrence of this complication always have limited positive warning value. This study aimed to evaluate whether elevated plasma levels of human neutrophil peptides (HNPs) 1–3 herald impaired lung function in infants and young children after cardiac surgery necessitating cardiopulmonary bypass (CPB). METHODS: Consecutive children younger than 3 years old who underwent cardiac surgery were prospectively enrolled. Plasma concentrations of HNPs 1–3 and inflammatory cytokines were measured before, and immediately after CPB, as well as at 1 h, 12 h, and 24 h after CPB. RESULTS: Thirty patients were enrolled, 18 (60%) of whom were infants. Plasma levels of HNPs 1–3 and the pro-inflammatory cytokine interleukin-6 (IL-6) significantly increased immediately after CPB (P < 0.001), while IL-8 increased 1 h after the CPB operation (P = 0.002). The anti-inflammatory cytokine IL-10 levels were also significantly elevated immediately after CPB compared with the baseline (P < 0.001). The stepwise multiple linear regression analysis showed that the plasma HNPs 1–3 levels immediately after CPB was independent correlated with the declined lung function, as reflected by the PaO(2)/FiO(2) ratio on the first 2 days after operation (for the first day: OR, −1.067, 95% CI, −0.548 to −1.574; P < 0.001; for the second day: OR, −0.667, 95% CI, −0.183 to −1.148; P = 0.009) and prolonged mechanical ventilation time (OR, 0.039, 95% CI, 0.005 to 0.056; P = 0.011). Plasma levels of HNPs 1–3 and IL-10 returned to the baseline values, while IL-6 and IL-8 levels remained significantly higher than baseline 24 h after CPB (P ≤ 0.01). CONCLUSIONS: Elevated HNPs 1–3 levels immediately after CPB correlate with impaired lung function, and HNPs 1–3 could serve as a quantifiable early alarmin biomarker for onset of lung injury in infants and young children undergoing cardiac surgery with CPB. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12890-017-0558-4) contains supplementary material, which is available to authorized users.
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spelling pubmed-57459922018-01-03 Plasma levels of alarmin HNPs 1–3 associate with lung dysfunction after cardiac surgery in children Liu, XiWang Chen, QiXing Luo, YuJia Hu, YaoQin Lai, DengMing Zhang, XiaoLe Zhang, XiangHong Yu, JianGen Fang, XiangMing Shu, Qiang BMC Pulm Med Research Article BACKGROUND: Early onset of lung injury is considerable common after cardiac surgery and is associated with increasing in morbidity and mortality, but current clinical predictors for the occurrence of this complication always have limited positive warning value. This study aimed to evaluate whether elevated plasma levels of human neutrophil peptides (HNPs) 1–3 herald impaired lung function in infants and young children after cardiac surgery necessitating cardiopulmonary bypass (CPB). METHODS: Consecutive children younger than 3 years old who underwent cardiac surgery were prospectively enrolled. Plasma concentrations of HNPs 1–3 and inflammatory cytokines were measured before, and immediately after CPB, as well as at 1 h, 12 h, and 24 h after CPB. RESULTS: Thirty patients were enrolled, 18 (60%) of whom were infants. Plasma levels of HNPs 1–3 and the pro-inflammatory cytokine interleukin-6 (IL-6) significantly increased immediately after CPB (P < 0.001), while IL-8 increased 1 h after the CPB operation (P = 0.002). The anti-inflammatory cytokine IL-10 levels were also significantly elevated immediately after CPB compared with the baseline (P < 0.001). The stepwise multiple linear regression analysis showed that the plasma HNPs 1–3 levels immediately after CPB was independent correlated with the declined lung function, as reflected by the PaO(2)/FiO(2) ratio on the first 2 days after operation (for the first day: OR, −1.067, 95% CI, −0.548 to −1.574; P < 0.001; for the second day: OR, −0.667, 95% CI, −0.183 to −1.148; P = 0.009) and prolonged mechanical ventilation time (OR, 0.039, 95% CI, 0.005 to 0.056; P = 0.011). Plasma levels of HNPs 1–3 and IL-10 returned to the baseline values, while IL-6 and IL-8 levels remained significantly higher than baseline 24 h after CPB (P ≤ 0.01). CONCLUSIONS: Elevated HNPs 1–3 levels immediately after CPB correlate with impaired lung function, and HNPs 1–3 could serve as a quantifiable early alarmin biomarker for onset of lung injury in infants and young children undergoing cardiac surgery with CPB. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12890-017-0558-4) contains supplementary material, which is available to authorized users. BioMed Central 2017-12-28 /pmc/articles/PMC5745992/ /pubmed/29282039 http://dx.doi.org/10.1186/s12890-017-0558-4 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Liu, XiWang
Chen, QiXing
Luo, YuJia
Hu, YaoQin
Lai, DengMing
Zhang, XiaoLe
Zhang, XiangHong
Yu, JianGen
Fang, XiangMing
Shu, Qiang
Plasma levels of alarmin HNPs 1–3 associate with lung dysfunction after cardiac surgery in children
title Plasma levels of alarmin HNPs 1–3 associate with lung dysfunction after cardiac surgery in children
title_full Plasma levels of alarmin HNPs 1–3 associate with lung dysfunction after cardiac surgery in children
title_fullStr Plasma levels of alarmin HNPs 1–3 associate with lung dysfunction after cardiac surgery in children
title_full_unstemmed Plasma levels of alarmin HNPs 1–3 associate with lung dysfunction after cardiac surgery in children
title_short Plasma levels of alarmin HNPs 1–3 associate with lung dysfunction after cardiac surgery in children
title_sort plasma levels of alarmin hnps 1–3 associate with lung dysfunction after cardiac surgery in children
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5745992/
https://www.ncbi.nlm.nih.gov/pubmed/29282039
http://dx.doi.org/10.1186/s12890-017-0558-4
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