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Histamine release during paediatric cardiopulmonary bypass
D E Withington1, W K Man, M J Elliott
1Department of Anaesthesia, St. Thomas' Hospital, London, U.K.
Summary
Histamine release during pediatric cardiopulmonary bypass (CPB) is minimal, with slight increases observed in some children. No significant correlation was found with CPB duration or other factors, but heart rate showed a positive association.
Area of Science:
- Cardiovascular Surgery
- Pediatric Anesthesiology
- Inflammatory Response
Background:
- Histamine release is a known inflammatory response during adult surgery and cardiopulmonary bypass (CPB).
- Limited data exist regarding histamine release in pediatric patients undergoing CPB.
Purpose of the Study:
- To investigate histamine release in children during CPB.
- To correlate plasma histamine levels with specific anesthetic and surgical events.
Main Methods:
- Studied 23 children undergoing CPB using standard techniques.
- Collected blood samples at key surgical and anesthetic events.
- Measured plasma histamine using a radioenzymatic technique.
Main Results:
- No consistent histamine release was observed in the pediatric study population.
- A statistically significant increase in plasma histamine occurred after CPB initiation (P < 0.05) and aortic cross-clamp removal (P < 0.05) in some subjects.
- No correlation was found between histamine levels and systolic arterial pressure, temperature, CPB duration, or cross-clamp time.
- A positive correlation was observed between histamine concentration and heart rate.
Conclusions:
- Histamine release during pediatric CPB is generally not significant.
- Minor, transient increases in histamine may occur, particularly after CPB initiation and aortic clamp removal.
- Heart rate appears to be a factor associated with histamine levels in this population.