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Postoperative Pulmonary Hemodynamics and Systemic Inflammatory Response in Pediatric Patients Undergoing Surgery for Congenital Heart Defects

There is scarce information about the relationships between postoperative pulmonary hemodynamics, inflammation, and outcomes in pediatric patients with congenital cardiac communications undergoing surgery. We prospectively studied 40 patients aged 11 (8–17) months (median with interquartile range) w...

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Autores principales: Souza, Maria Francilene S., Penha, Juliano G., Maeda, Nair Y., Galas, Filomena R. B. G., Abud, Kelly C. O., Carvalho, Eloisa S., Thomaz, Ana Maria, Castro, Claudia R. P., Pereira, Juliana, Lopes, Antonio Augusto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8783708/
https://www.ncbi.nlm.nih.gov/pubmed/35075348
http://dx.doi.org/10.1155/2022/3977585
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author Souza, Maria Francilene S.
Penha, Juliano G.
Maeda, Nair Y.
Galas, Filomena R. B. G.
Abud, Kelly C. O.
Carvalho, Eloisa S.
Thomaz, Ana Maria
Castro, Claudia R. P.
Pereira, Juliana
Lopes, Antonio Augusto
author_facet Souza, Maria Francilene S.
Penha, Juliano G.
Maeda, Nair Y.
Galas, Filomena R. B. G.
Abud, Kelly C. O.
Carvalho, Eloisa S.
Thomaz, Ana Maria
Castro, Claudia R. P.
Pereira, Juliana
Lopes, Antonio Augusto
author_sort Souza, Maria Francilene S.
collection PubMed
description There is scarce information about the relationships between postoperative pulmonary hemodynamics, inflammation, and outcomes in pediatric patients with congenital cardiac communications undergoing surgery. We prospectively studied 40 patients aged 11 (8–17) months (median with interquartile range) with a preoperative mean pulmonary arterial pressure of 48 (34–54) mmHg who were considered to be at risk for postoperative pulmonary hypertension. The immediate postoperative pulmonary/systemic mean arterial pressure ratio (PAP/SAP(IPO), mean of first 4 values obtained in the intensive care unit, readings at 2-hour intervals) was correlated directly with PAP/SAP registered in the surgical room just after cardiopulmonary bypass (r = 0.68, p < 0.001). For the entire cohort, circulating levels of 15 inflammatory markers changed after surgery. Compared with patients with PAP/SAP(IPO) ≤ 0.40 (n = 22), those above this level (n = 18) had increased pre- and postoperative serum levels of granulocyte colony-stimulating factor (p = 0.040), interleukin-1 receptor antagonist (p = 0.020), interleukin-6 (p = 0.003), and interleukin-21 (p = 0.047) (panel for 36 human cytokines) and increased mean platelet volume (p = 0.018). Using logistic regression analysis, a PAP/SAP(IPO) > 0.40 and a heightened immediate postoperative serum level of macrophage migration inhibitory factor (quartile analysis) were shown to be predictive of significant postoperative cardiopulmonary events (respective hazard ratios with 95% CIs, 5.07 (1.10–23.45), and 3.29 (1.38–7.88)). Thus, the early postoperative behavior of the pulmonary circulation and systemic inflammatory response are closely related and can be used to predict outcomes in this population.
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spelling pubmed-87837082022-01-23 Postoperative Pulmonary Hemodynamics and Systemic Inflammatory Response in Pediatric Patients Undergoing Surgery for Congenital Heart Defects Souza, Maria Francilene S. Penha, Juliano G. Maeda, Nair Y. Galas, Filomena R. B. G. Abud, Kelly C. O. Carvalho, Eloisa S. Thomaz, Ana Maria Castro, Claudia R. P. Pereira, Juliana Lopes, Antonio Augusto Mediators Inflamm Research Article There is scarce information about the relationships between postoperative pulmonary hemodynamics, inflammation, and outcomes in pediatric patients with congenital cardiac communications undergoing surgery. We prospectively studied 40 patients aged 11 (8–17) months (median with interquartile range) with a preoperative mean pulmonary arterial pressure of 48 (34–54) mmHg who were considered to be at risk for postoperative pulmonary hypertension. The immediate postoperative pulmonary/systemic mean arterial pressure ratio (PAP/SAP(IPO), mean of first 4 values obtained in the intensive care unit, readings at 2-hour intervals) was correlated directly with PAP/SAP registered in the surgical room just after cardiopulmonary bypass (r = 0.68, p < 0.001). For the entire cohort, circulating levels of 15 inflammatory markers changed after surgery. Compared with patients with PAP/SAP(IPO) ≤ 0.40 (n = 22), those above this level (n = 18) had increased pre- and postoperative serum levels of granulocyte colony-stimulating factor (p = 0.040), interleukin-1 receptor antagonist (p = 0.020), interleukin-6 (p = 0.003), and interleukin-21 (p = 0.047) (panel for 36 human cytokines) and increased mean platelet volume (p = 0.018). Using logistic regression analysis, a PAP/SAP(IPO) > 0.40 and a heightened immediate postoperative serum level of macrophage migration inhibitory factor (quartile analysis) were shown to be predictive of significant postoperative cardiopulmonary events (respective hazard ratios with 95% CIs, 5.07 (1.10–23.45), and 3.29 (1.38–7.88)). Thus, the early postoperative behavior of the pulmonary circulation and systemic inflammatory response are closely related and can be used to predict outcomes in this population. Hindawi 2022-01-15 /pmc/articles/PMC8783708/ /pubmed/35075348 http://dx.doi.org/10.1155/2022/3977585 Text en Copyright © 2022 Maria Francilene S. Souza et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Souza, Maria Francilene S.
Penha, Juliano G.
Maeda, Nair Y.
Galas, Filomena R. B. G.
Abud, Kelly C. O.
Carvalho, Eloisa S.
Thomaz, Ana Maria
Castro, Claudia R. P.
Pereira, Juliana
Lopes, Antonio Augusto
Postoperative Pulmonary Hemodynamics and Systemic Inflammatory Response in Pediatric Patients Undergoing Surgery for Congenital Heart Defects
title Postoperative Pulmonary Hemodynamics and Systemic Inflammatory Response in Pediatric Patients Undergoing Surgery for Congenital Heart Defects
title_full Postoperative Pulmonary Hemodynamics and Systemic Inflammatory Response in Pediatric Patients Undergoing Surgery for Congenital Heart Defects
title_fullStr Postoperative Pulmonary Hemodynamics and Systemic Inflammatory Response in Pediatric Patients Undergoing Surgery for Congenital Heart Defects
title_full_unstemmed Postoperative Pulmonary Hemodynamics and Systemic Inflammatory Response in Pediatric Patients Undergoing Surgery for Congenital Heart Defects
title_short Postoperative Pulmonary Hemodynamics and Systemic Inflammatory Response in Pediatric Patients Undergoing Surgery for Congenital Heart Defects
title_sort postoperative pulmonary hemodynamics and systemic inflammatory response in pediatric patients undergoing surgery for congenital heart defects
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8783708/
https://www.ncbi.nlm.nih.gov/pubmed/35075348
http://dx.doi.org/10.1155/2022/3977585
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