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Isolation of Endothelial Progenitor Cells from Healthy Volunteers and Their Migratory Potential Influenced by Serum Samples After Cardiac Surgery
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Inflammatory cytokines in pediatric cardiac surgery and variable effect of the hemofiltration process

Gianluca Brancaccio1, Emmanuel Villa, Elia Girolami

  • 1Pediatric Cardiac Surgery, Bambino Gesù Children's Hospital, Rome, Italy. gbrancaccio70@hotmail.com

Perfusion
|October 20, 2005
PubMed

Insights

Pediatric cardiac surgery triggers inflammation. Hemofiltration effectively reduced tumor necrosis factor-alpha (TNF-alpha) levels, but its impact on other cytokines like Interleukin-6 (IL-6) was limited.

Area of Science:

  • Cardiovascular Surgery
  • Pediatric Cardiology
  • Immunology

Background:

  • Cardiac surgery with cardiopulmonary bypass (CPB) induces an inflammatory response, particularly in pediatric patients.
  • Cytokines are key mediators of this response, making their modulation a therapeutic target.

Purpose of the Study:

  • To investigate cytokine release patterns during pediatric congenital heart anomaly surgery.
  • To evaluate the effect of hemofiltration on these cytokine levels.

Main Methods:

  • Studied 20 pediatric patients undergoing congenital heart anomaly surgery.
  • Monitored cytokine levels (TNF-alpha, IL-1, IL-6, sIL-6r, IL-8) during and after CPB.
  • Assessed the impact of hemofiltration on cytokine concentrations.

Main Results:

  • Tumor necrosis factor-alpha (TNF-alpha) increased post-anesthesia, decreased during CPB, and was reduced by hemofiltration, though this effect was transient.
  • Interleukin-1 (IL-1), Interleukin-6 (IL-6), and Interleukin-8 (IL-8) showed different patterns, with IL-6 and IL-8 tending to increase during rewarming.
  • Hemofiltration had no significant effect on IL-1, IL-6, soluble IL-6 receptor (sIL-6r), or IL-8 levels.

Conclusions:

  • Cytokine release is influenced by pre-operative factors and the rewarming phase of CPB.
  • Hemofiltration demonstrates efficacy in reducing TNF-alpha but has a debatable role in controlling other key inflammatory cytokines in pediatric cardiac surgery.

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