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Complement, leukocytes, and leukocyte elastase in full-term neonates undergoing cardiac operation
M C Seghaye1, J Duchateau, R G Grabitz
1Department of Pediatric Cardiology, RWTH Aachen, Germany.
The Journal of Thoracic and Cardiovascular Surgery
|July 1, 1994
Summary
This study shows that cardiopulmonary bypass in neonates activates complement and leukocytes, indicated by rising C3d/C3 and C5a levels and changes in leukocyte counts. These immune responses did not correlate with patient outcomes.
Area of Science:
- Cardiovascular Surgery
- Immunology
- Neonatal Medicine
Background:
- Congenital cardiac defects often require surgical intervention.
- Cardiopulmonary bypass (CPB) is a critical procedure in neonatal cardiac surgery.
- The immunological impact of CPB in neonates is not fully understood.
Purpose of the Study:
- To investigate complement system activation and leukocyte response during CPB in neonates.
- To assess the correlation between these immune responses and postoperative outcomes.
Main Methods:
- Studied complement, leukocytes, and leukocyte elastase in 13 neonates during and after CPB.
- Measured C3d/C3 ratio, C5a levels, leukocyte and neutrophil counts, and elastase release.
- Administered prostaglandin E1 to most neonates preoperatively.
Main Results:
- Significant increase in C3d/C3 ratio and elevated C5a levels during CPB.
- Marked decrease in leukocyte and neutrophil counts at the start of CPB, followed by a rise post-CPB.
- Elastase release was observed in all neonates during CPB.
- No correlation found between complement activation, leukocyte stimulation, and postoperative complications or outcomes.
Conclusions:
- Neonatal cardiac operations involving CPB trigger significant complement activation and leukocyte stimulation.
- Despite observed immune responses, they did not predict postoperative complications or outcomes in this cohort.
- Further research may be needed to elucidate the clinical significance of CPB-induced immune changes in neonates.