Clinical and Experimental Pediatrics

대한소아청소년과학회 (The Korean Pediatric Society)
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Outcome of inflammatory response after normothermia during cardiopulmonary bypass surgery in infants with isolated ventricular septal defect

  • 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)
  • 투고 : 2013.09.15
  • 심사 : 2013.11.18
  • 발행 : 2014.05.15
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초록

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.

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참고문헌

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피인용 문헌

  1. The Relationship Between Neutrophil to Lymphocyte Ratio and Clinical Outcome in Pediatric Patients After Cardiopulmonary Bypass Surgery: A Retrospective Study vol.7, pp.None, 2014, https://doi.org/10.3389/fped.2019.00308
  2. Safety of Normothermic Cardiopulmonary Bypass in Pediatric Cardiac Surgery: A System Review and Meta-Analysis vol.9, pp.None, 2014, https://doi.org/10.3389/fped.2021.757551
  3. C‐reactive protein and procalcitonin after congenital heart surgery utilizing cardiopulmonary bypass: When should we be worried? vol.36, pp.11, 2014, https://doi.org/10.1111/jocs.15952