Endothelial Glycocalyx Disruption After Cardiac Surgery in Infants
Author Information
Author(s): Sheward V, Tibby S, Bangalore H, Durward A, Murdoch I
Primary Institution: Evelina Children's Hospital, London, UK
Hypothesis
Cardiopulmonary bypass would elevate markers of EGX shedding, which would be associated with increased postoperative inflammation.
Conclusion
Markers of EGX disruption show a reproducible temporal profile after bypass, but their significance is unclear due to lack of correlation with inflammation and clinical markers.
Supporting Evidence
- Infants showed a dramatic rise in SYND, peaking at the end of bypass.
- The median peak SYND levels were 144 ng/ml, representing a sixfold rise from baseline.
- Peak IL-6 occurred at 12 hours post bypass with a median of 118 pg/ml.
- Peak IL-6 correlated with bypass time, length of ventilation, and ICU stay.
Takeaway
The study looked at how a part of blood vessels gets damaged during heart surgery in babies, but it didn't find a clear link to inflammation.
Methodology
A prospective cohort study measuring markers of EGX disruption and inflammation in infants undergoing cardiac surgery.
Limitations
The correlation between EGX markers and clinical outcomes was poor.
Participant Demographics
Infants undergoing surgery for congenital heart disease, median weight 5 kg.
Statistical Information
Confidence Interval
113 to 190 for SYND, 44 to 217 for IL-6
Digital Object Identifier (DOI)
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