Feeding May Modulate the Relationship Between Systemic Inflammation, Insulin Resistance, and Poor Outcome Following Cardiopulmonary Bypass for Pediatric Cardiac Surgery

2019 ◽  
Vol 44 (2) ◽  
pp. 308-317 ◽  
Author(s):  
Alejandro A. Floh ◽  
Brian W. McCrindle ◽  
Cedric Manlhiot ◽  
Masayuki Nakada ◽  
Gustavo La Rotta ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Systemic Inflammation ◽  
Pediatric Cardiac Surgery ◽  
Poor Outcome ◽  
The Relationship

scholarly journals Relationships of Adiponectin with Markers of Systemic Inflammation and Insulin Resistance in Infants Undergoing Open Cardiac Surgery

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Yukun Cao ◽  
Ting Yang ◽  
Shiqiang Yu ◽  
Guocheng Sun ◽  
Chunhu Gu ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Systemic Inflammation ◽  
Insulin Requirement ◽  
Glycaemic Index ◽  
Repeated Measurements ◽  
Inverse Association ◽  
Necrosis Factor Alpha ◽  
Blood Samples

Background. Insulin resistance and systemic inflammation frequently occur in infants undergoing cardiac surgery with cardiopulmonary bypass, while adiponectin has been demonstrated to have insulin-sensitizing and anti-inflammatory properties in obesity and type 2 diabetes mellitus. In this prospective study, we aimed to investigate the association of adiponectin with insulin resistance and inflammatory mediators in infants undergoing cardiac surgery with cardiopulmonary bypass.Methods and Results. From sixty infants undergoing open cardiac surgery, blood samples were taken before anesthesia, at the initiation of cardiopulmonary bypass and at 0, 6, 12, 24, and 48 hours after the termination of cardiopulmonary bypass. Plasma interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and adiponectin levels were assessed in blood samples. Insulin resistance was measured by assessment of the insulin requirement to maintain euglycaemia and repeated measurements of an insulin glycaemic index. Insulin glycaemic index, IL-6, and TNF-αincreased up to 3–8-fold 6 h after the operation. Adiponectin is negatively correlated with markers of systemic inflammation 6 h after CPB.Conclusions. Although the level of serum adiponectin decreased significantly, there was a significant inverse association of adiponectin with markers of systemic inflammation and insulin resistance in infants undergoing open cardiac surgery.

Relationship of Preoperative Thyroid Dysfunction to Clinical Outcomes in Pediatric Cardiac Surgery

2021 ◽  
Author(s):  
Morgan L Brown ◽  
Luis G Quinonez ◽  
Steven J Staffa ◽  
James A DiNardo ◽  
Ari J Wassner
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Thyroid Dysfunction ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Hospital Length ◽  
Pediatric Cardiac Surgery ◽  
Hospital Length Of Stay ◽  
Secondary Outcome ◽  
The Relationship

Abstract Context Thyroid function may be assessed in children before cardiac surgery because of concerns that hypothyroidism or thyrotoxicosis might adversely affect cardiac function perioperatively. However, the relationship between preoperative thyroid dysfunction and surgical outcomes is unknown. Objective Determine the relationship between preoperative thyroid dysfunction and outcomes of pediatric cardiac surgery. Methods Retrospective cohort study (January 2005 to July 2019). Setting Academic pediatric hospital. Patients All patients <19 years old who underwent cardiac surgery with cardiopulmonary bypass and had thyrotropin (TSH) measured within 14 days preoperatively. Exclusion criteria included neonates (≤30 days), preoperative extracorporeal life support, salvage operations, or transplantation procedures. Main Outcome Measures Subjects were stratified by preoperative TSH concentration (mIU/L): low (<0.5), normal (0.5-5), mildly high (5.01-10), or moderately high (>10). Outcomes were compared among subjects with normal TSH (control) and each group with abnormal TSH concentrations. The primary outcome was 30-day mortality. Secondary outcomes included time to extubation, intensive care unit and hospital length of stay, and operative complications. Results Among 592 patients analyzed, preoperative TSH was low in 15 (2.5%), normal in 347 (58.6%), mildly high in 177 (29.9%), and moderately high in 53 (9.0%). Free thyroxine was measured in 77.4% of patients and was low in 0 to 4.4% of subjects, with no differences among TSH groups. Thirty-day mortality was similar among TSH groups. There were no differences in any secondary outcome between patients with abnormal TSH and patients with normal TSH. Conclusion Preoperative mild to moderate subclinical hypothyroidism was not associated with adverse postoperative outcomes in children undergoing cardiopulmonary bypass procedures.

Transfusion Practices in Pediatric Cardiac Surgery Requiring Cardiopulmonary Bypass

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Sheila J. Hanson ◽  
Oliver Karam ◽  
Rebecca Birch ◽  
Ruchika Goel ◽  
Ravi M. Patel ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Pediatric Cardiac Surgery

The Effects of Cardiopulmonary Bypass Following Pediatric Cardiac Surgery

2020 ◽  
pp. 113-129 ◽  
Author(s):  
Ana Maria Manrique ◽  
Diana P. Vargas ◽  
David Palmer ◽  
Kent Kelly ◽  
Steven E. Litchenstein
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Pediatric Cardiac Surgery

Clinical application of a new ternary polymer, SEC-1 coat™, for pediatric cardiopulmonary bypass circuits: a prospective randomized pilot study

Perfusion ◽  
2020 ◽  
Vol 35 (8) ◽  
pp. 826-832
Author(s):  
Tomomi Hasegawa ◽  
Yoshihiro Oshima ◽  
Shinji Yokoyama ◽  
Asuka Akimoto ◽  
Yusuke Misaka ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Pilot Study ◽  
Interleukin 6 ◽  
Patient Characteristics ◽  
Serum Levels ◽  
Pediatric Cardiac Surgery ◽  
Interleukin 8 ◽  
Control Group ◽  
Platelet Counts

Objective: The use of biocompatible materials to reduce the systemic activation of inflammation and coagulation pathways is expanding rapidly. However, there have been few clinical studies of biocompatible circuits for pediatric cardiopulmonary bypass. This pilot study aimed to preliminarily evaluate the biocompatibility of SEC-1 coat™ (SEC) for cardiopulmonary bypass circuits in pediatric cardiac surgery. Methods: Twenty infants undergoing cardiac surgery for isolated ventricular septal defects at Kobe Children’s Hospital were assigned randomly to an SEC-coated (SEC group, n = 10) or heparin-coated (control group, n = 10) circuit. Perioperative data and the following markers were prospectively analyzed: platelet counts and interleukin-6, interleukin-8, C3a, β-thromboglobulin, and thrombin–antithrombin complex levels. Results: Neither patient characteristics nor postoperative clinical outcomes differed significantly between the SEC and control groups. Platelet counts markedly decreased during cardiopulmonary bypass in both groups, but were significantly better preserved in the SEC group. Fewer patients needed postoperative platelet transfusions in the SEC group. After cardiopulmonary bypass termination, serum levels of β-thromboglobulin and thrombin–antithrombin complex were significantly lower in the SEC than in the control group. Although the differences were not statistically significant, serum levels of interleukin-6, interleukin-8, and C3a had a tendency toward being lower in the SEC group, with good preservation of leukocyte counts, fibrinogen, and antithrombin III. Conclusion: SEC-1 coat™ for cardiopulmonary bypass circuits have good biocompatibility with regard to platelet preservation and in terms of attenuating inflammatory reaction or coagulation activation during pediatric cardiac surgery. It can be beneficial in pediatric as well as adult cardiac surgery.

scholarly journals Risk factors for the development of significant postoperative bleeding after pediatric cardiac surgery with cardiopulmonary bypass: A nested case-control study

2017 ◽  
Vol 6 (3) ◽  
pp. 5
Author(s):  
JuanCarlos Núñez-Enríquez ◽  
IsabelZnaya Ramírez-Flores ◽  
Maribel Ibarra-Sarlat ◽  
Vivian Neme-Bechara ◽  
Alejandro Herrera-Landero ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Case Control Study ◽  
Postoperative Bleeding ◽  
Case Control ◽  
Pediatric Cardiac Surgery ◽  
Nested Case Control ◽  
Control Study

Modified ultrafiltration after cardiopulmonary bypass in pediatric cardiac surgery

1997 ◽  
Vol 64 (2) ◽  
pp. 521-525 ◽  
Author(s):  
Anjo M. Draaisma ◽  
Mark G. Hazekamp ◽  
Michael Frank ◽  
Nanning Anes ◽  
Paul H. Schoof ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Pediatric Cardiac Surgery

scholarly journals A Table Mounted Cardiopulmonary Bypass System for Pediatric Cardiac Surgery

2018 ◽  
Vol 106 (3) ◽  
pp. e163-e165 ◽  
Author(s):  
Ana Claudia B.A. Costa ◽  
Darren R. Parham ◽  
Justin E. Ashley ◽  
Khanh H. Nguyen
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Pediatric Cardiac Surgery
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