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Perioperative GABA Blood Concentrations in Infants with Cyanotic and Non-Cyanotic Congenital Heart Diseases

Angela Satriano1, Alessandro Varrica1, Alessandro Frigiola1

  • 1Department of Pediatric Cardiac Surgery IRCCS San Donato Milanese Hospital, 20097 San Donato Milanese, Italy.

Diagnostics (Basel, Switzerland)
|July 2, 2021
PubMed

Insights

Children with cyanotic congenital heart disease (CHD) show lower perioperative gamma-aminobutyric acid (GABA) blood levels compared to non-cyanotic CHD infants. This suggests increased vulnerability to cardiovascular and brain stress during surgery.

Area of Science:

  • Pediatric Cardiology
  • Neuroscience
  • Biochemistry

Background:

  • Perioperative stress detection in children with congenital heart disease (CHD), especially concerning the brain, remains challenging.
  • Gamma-aminobutyric acid (GABA), a neurotransmitter with cardiovascular and cerebral regulatory roles, is a potential biomarker for stress.
  • Understanding GABA's role in perioperative stress in CHD is crucial for improving patient outcomes.

Purpose of the Study:

  • To investigate changes in blood GABA levels during the perioperative period in infants with cyanotic (C) and non-cyanotic (N) CHD.
  • To compare GABA levels between cyanotic and non-cyanotic CHD infants and correlate them with oxygenation parameters.
  • To assess the potential of GABA as a biomarker for perioperative stress and brain injury in pediatric CHD patients.

Main Methods:

  • An observational study involving 68 infants with CHD (33 cyanotic, 35 non-cyanotic) undergoing surgery.
  • Blood samples for GABA assessment were collected at five perioperative time-points.
  • Clinical, laboratory, and monitoring parameters, including arterial oxygen saturation, were recorded.

Main Results:

  • No significant perioperative differences in clinical or laboratory parameters were found between the cyanotic and non-cyanotic groups.
  • Perioperative GABA levels were significantly lower in cyanotic CHD infants compared to non-cyanotic infants.
  • Arterial oxygen saturation and blood concentration differed between groups and correlated with GABA levels during cardiopulmonary bypass.

Conclusions:

  • Lower perioperative GABA levels in cyanotic CHD infants suggest increased susceptibility to cardiovascular and brain stress/damage.
  • Hypoxia/hyperoxia during cardiopulmonary bypass may influence GABA concentrations in cyanotic CHD patients.
  • Further research is needed to determine optimal oxygen targets during cardiopulmonary bypass to mitigate perioperative stress in CHD.

Keywords:
GABAbraincardiopulmonary by-passchildrencoolingnewbornreoxygenation

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