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Perioperative lymphocyte adenylyl cyclase function in the pediatric cardiac surgical patient
L S Sun1, C B Pantuck, J J Morelli
1Department of Anesthesiology, Collage of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.
Insights
Pediatric cardiac surgery patients showed increased lymphocyte adenylyl cyclase activity during cardiopulmonary bypass. Postoperatively, this activity decreased, indicating beta-adrenergic receptor desensitization in children.
Area of Science:
- Pediatric cardiac surgery
- Immunology
- Cardiopulmonary bypass
Background:
- Congenital cardiac defects require surgical repair using cardiopulmonary bypass.
- Understanding the impact of cardiopulmonary bypass on immune cell function is crucial for pediatric surgical patients.
Purpose of the Study:
- To investigate intraoperative and postoperative changes in lymphocyte adenylyl cyclase activity.
- To assess the effects of hypothermic cardiopulmonary bypass on immune responses in children undergoing cardiac repair.
Main Methods:
- Prospective study conducted at a tertiary university pediatric hospital.
- Involved twelve children for intraoperative and twelve for postoperative assessments.
- Measured basal, isoproterenol, and prostaglandin E1-stimulated adenylyl cyclase activities, along with plasma catecholamines.
Main Results:
- Intraoperative lymphocyte adenylyl cyclase activities (basal, beta-adrenergic, and PGE1-stimulated) increased during cardiopulmonary bypass and decreased immediately after.
- Postoperative day 1 showed a significant decrease in basal, beta-adrenergic, and PGE1-stimulated adenylyl cyclase activities compared to pre-bypass levels.
Conclusions:
- Pediatric cardiac surgery patients exhibit enhanced lymphocyte adenylyl cyclase activity during cardiopulmonary bypass.
- Postoperative reduction in lymphocyte adenylyl cyclase activity, including beta-adrenergic receptor desensitization, was observed, consistent with findings in adult patients.
Objective:
To examine intraoperative and postoperative lymphocyte adenylyl cyclase activities in children undergoing repair of congenital cardiac defects with hypothermic cardiopulmonary bypass.
Design:
A prospective study.
Setting:
Tertiary university pediatric hospital.
Patients:
Twelve children were enrolled into the study to examine intraoperative lymphocyte adenylyl cyclase activities and 12 children were enrolled to examine postoperative lymphocyte adenylyl cyclase activities.
Interventions:
None.
Measurements And Main Results:
Basal (unstimulated), isoproterenol, and prostaglandin E-1 stimulated adenylyl cyclase activities, and plasma norepinephrine and epinephrine concentrations were measured. Intraoperative basal (unstimulated), beta-adrenergic receptor-stimulated (in response to isoproterenol), and prostaglandin E1 (PGE1)-stimulated lymphocyte adenylyl cyclase activities all increased during cardiopulmonary bypass, then decreased immediately after cardiopulmonary bypass. In the postoperative group, a significant decrease in basal (unstimulated), beta-adrenergic receptor- and PGE1-stimulated adenylyl cyclase activities were observed on postoperative day 1 as compared with precardiopulmonary bypass values.
Conclusions:
In the pediatric cardiac surgical patient, there was an intraoperative enhancement of lymphocyte adenylyl cyclase activities. This increase in adenylyl cyclase activities was followed by reduced lymphocyte adenylyl cyclase activities, including beta-adrenergic receptor desensitization, postoperatively, as we have previously documented in adults.