Kim, Dong Sub
(Department of Pediatrics, Kyungpook National University School of Medicine)
,
Lee, Sang In
(Department of Pediatrics, Kyungpook National University School of Medicine)
,
Lee, Sang Bum
(Department of Pediatrics, Kyungpook National University School of Medicine)
,
Hyun, Myung Chul
(Department of Pediatrics, Kyungpook National University School of Medicine)
,
Cho, Joon Yong
(Department of Thoracic & Cardiovascular Surgery, Kyungpook National University School of Medicine)
,
Lee, Young Ok
(Department of Thoracic & Cardiovascular Surgery, Kyungpook National University School of Medicine)
Purpose: A recent study analyzing several cytokines reported that long cardiopulmonary bypass (CPB) time and long aortic cross clamp (ACC) time were accompanied by enhanced postoperative inflammation, which contrasted with the modest influence of the degree of hypothermia. In this present study, we ...
Purpose: A recent study analyzing several cytokines reported that long cardiopulmonary bypass (CPB) time and long aortic cross clamp (ACC) time were accompanied by enhanced postoperative inflammation, which contrasted with the modest influence of the degree of hypothermia. In this present study, we aimed to examine the effect of CPB temperature on the clinical outcome in infants undergoing repair of isolated ventricular septal defect (VSD). Methods: Of the 212 infants with isolated VSD who underwent open heart surgery (OHS) between January 2001 and December 2010, 43 infants were enrolled. They were classified into 2 groups: group 1, infants undergoing hypothermic CPB ($26^{\circ}C-28^{\circ}C$; n=19) and group 2, infants undergoing near-normothermic CPB ($34^{\circ}C-36^{\circ}C$; n=24). Results: The age at the time of the OHS, and number of infants aged<3 months showed no significant differences between the groups. The CPB time and ACC time in group 1 were longer than those in group 2 (88 minutes vs. 59 minutes, P =0.002, and 54 minutes vs. 37 minutes, P =0.006 respectively). The duration of postoperative mechanical ventilation was 1.6 days in group 1 and 1.8 days in group 2. None of the infants showed postoperative neurological and developmental abnormalities. Moreover, no postoperative differences in the white blood cell count and C-reactive protein levels were noted between two groups. Conclusion: This study revealed that hypothermic and near-normothermic CPB were associated with similar clinical outcomes and inflammatory reactions in neonates and infants treated for simple congenital heart disease.
Purpose: A recent study analyzing several cytokines reported that long cardiopulmonary bypass (CPB) time and long aortic cross clamp (ACC) time were accompanied by enhanced postoperative inflammation, which contrasted with the modest influence of the degree of hypothermia. In this present study, we aimed to examine the effect of CPB temperature on the clinical outcome in infants undergoing repair of isolated ventricular septal defect (VSD). Methods: Of the 212 infants with isolated VSD who underwent open heart surgery (OHS) between January 2001 and December 2010, 43 infants were enrolled. They were classified into 2 groups: group 1, infants undergoing hypothermic CPB ($26^{\circ}C-28^{\circ}C$; n=19) and group 2, infants undergoing near-normothermic CPB ($34^{\circ}C-36^{\circ}C$; n=24). Results: The age at the time of the OHS, and number of infants aged<3 months showed no significant differences between the groups. The CPB time and ACC time in group 1 were longer than those in group 2 (88 minutes vs. 59 minutes, P =0.002, and 54 minutes vs. 37 minutes, P =0.006 respectively). The duration of postoperative mechanical ventilation was 1.6 days in group 1 and 1.8 days in group 2. None of the infants showed postoperative neurological and developmental abnormalities. Moreover, no postoperative differences in the white blood cell count and C-reactive protein levels were noted between two groups. Conclusion: This study revealed that hypothermic and near-normothermic CPB were associated with similar clinical outcomes and inflammatory reactions in neonates and infants treated for simple congenital heart disease.
* AI 자동 식별 결과로 적합하지 않은 문장이 있을 수 있으니, 이용에 유의하시기 바랍니다.
제안 방법
This study evaluated through laboratory findings whether hypothermia during OHS is related to inflammation in infants undergoing OHS.
This study has limitations. This study was designed under the retrospective chart review and could only include WBC count and CRP as inflammatory markers. Cytokines could not be included.
대상 데이터
Between January 2001 and December 2010, 621 infants underwent OHS in Kyungpook National University Medical Center. Among them, 212 patients were VSD patients. The lowest bypass temperature of hypothermia (26℃–29℃) and nearnormothermia (34℃–36℃) were selected3) (Fig.
데이터처리
05 were considered to be statistically significant. To examine changes over time after surgery, mixed model analysis were employed using PASW statistics 18.0 (SPSS Inc., Chicago, IL, USA).
Values are expressed as the mean±standard deviation. Univa riate comparisons of continuous variables were conducted using the unpaired Student t test. Univariate analyses of the differences in proportion between the two groups were accomplished using the chi-square analysis.
Univa riate comparisons of continuous variables were conducted using the unpaired Student t test. Univariate analyses of the differences in proportion between the two groups were accomplished using the chi-square analysis. Differences with a P value of <0.
참고문헌 (13)
1 Paparella D Yau TM Young E Cardiopulmonary bypass induced inflammation: pathophysiology and treatment. An update Eur J Cardiothorac Surg 2002 21 232 244 11825729
2 Corno AF von Segesser LK Is hypothermia necessary in pediatric cardiac surgery? Eur J Cardiothorac Surg 1999 15 110 111 10077386
3 Stocker CF Shekerdemian LS Horton SB Lee KJ Eyres R D'Udekem Y The influence of bypass temperature on the systemic inflammatory response and organ injury after pediatric open surgery: a randomized trial J Thorac Cardiovasc Surg 2011 142 174 180 21420106
4 Eggum R Ueland T Mollnes TE Videm V Aukrust P Fiane AE Effect of perfusion temperature on the inflammatory response during pediatric cardiac surgery Ann Thorac Surg 2008 85 611 617 18222275
5 Scully BB Morales DL Zafar F McKenzie ED Fraser CD Jr Heinle JS Current expectations for surgical repair of isolated ventricular septal defects Ann Thorac Surg 2010 89 544 549 20103339
6 Kogon B Butler H Kirshbom P Kanter K McConnell M Closure of symptomatic ventricular septal defects: how early is too early? Pediatr Cardiol 2008 29 36 39 17676370
7 Mahle WT Lundine K Kanter KR Forbess JM Kirshbom P Tosone SR The short term effects of cardiopulmonary bypass on neurologic function in children and young adults Eur J Cardiothorac Surg 2004 26 920 925 15519183
8 Hövels-Gürich HH Schumacher K Vazquez-Jimenez JF Qing M Huffmeier U Buding B Cytokine balance in infants undergoing cardiac operation Ann Thorac Surg 2002 73 601 608 11845881
9 Beghetti M Rimensberger PC Kalangos A Habre W Gervaix A Kinetics of procalcitonin, interleukin 6 and C-reactive protein after cardiopulmonary-bypass in children Cardiol Young 2003 13 161 167 12887072
10 Allan CK Newburger JW McGrath E Elder J Psoinos C Laussen PC The relationship between inflammatory activation and clinical outcome after infant cardiopulmonary bypass Anesth Analg 2010 111 1244 1251 20829561
11 Rossaint J Berger C Van Aken H Scheld HH Zahn PK Rukosujew A Cardiopulmonary bypass during cardiac surgery modulates systemic inflammation by affecting different steps of the leukocyte recruitment cascade PLoS One 2012 7 e45738 23029213
12 Gazmuri RJ Gopalakrishnan P Hypothermia: cooling down inflammation Crit Care Med 2003 31 2811 2812 14668624
13 Walther T Rastan A Dahnert I Jacobs S Scheer K Wild F Moderate versus deep hypothermia for arterial switch operation Thorac Cardiovasc Surg 2006 54 255 258 16755447
※ AI-Helper는 부적절한 답변을 할 수 있습니다.