HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Thierry Carrel Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Gessler, P. Articles by Dahinden, C. Search for Related Content PubMed PubMed Citation Articles by Gessler, P. Articles by Dahinden, C. Related Collections Myocardial protection

J Thorac Cardiovasc Surg 2003;126:718-725
© 2003 The American Association for Thoracic Surgery

Surgery for congenital heart disease

Plasma levels of interleukin-8 and expression of interleukin-8 receptors on circulating neutrophils and monocytes after cardiopulmonary bypass in children

^a University Children’s Hospital, Zurich, Switzerland
^b University Children’s Hospital, Berne, Switzerland
^c Department of Cardiovascular Surgery, University Hospital, Berne, Switzerland
^d Institute of Immunology, University of Berne, Berne, Switzerland

Received for publication October 8, 2002; revisions received November 25, 2002; revisions received December 3, 2002; accepted for publication January 10, 2003.

^* Address for reprints: Peter Gessler, MD, University Children’s Hospital, Steinwiesstr. 75, CH 8032, Zurich, Switzerland
peter.gessler{at}kispi.unizh.ch

OBJECTIVE: Cardiopulmonary bypass induces a systemic inflammatory response that causes substantial clinical morbidity. This study sought to determine cellular and humoral variables of inflammation. We hypothesized that chemokines are a major source of stimulation of neutrophils and monocytes in pediatric cardiac surgery.

METHODS: We performed an observational prospective clinical study of 20 pediatric patients before and after cardiopulmonary bypass. Plasma levels of interleukin-6, interleukin-8, myeloperoxidase, and nitric oxide were measured by immunoassays. Expression of interleukin-8 receptors (CXCR1, CXCR2) and CD14 of circulating neutrophils and monocytes was assessed by flow cytometry. Clinical evaluations included length of inotropic support and mechanical ventilation as well as oxygenation.

RESULTS: Two hours after cardiopulmonary bypass, plasma levels of interleukin-6 and interleukin-8 were strongly increased (P = .0001 and P = .0032, respectively). Interleukin-6 and interleukin-8 concentrations correlated with the length of inotropic support, as well as with the length of mechanical ventilation (r > .70, P .0006), and were inversely related to the ratio of arterial oxygen tension to fraction of inspired oxygen. There was a strong association between the postoperative levels of interleukin-6 and nitric oxide, as well as between interleukin-6 and CD14 expression on monocytes (r > .62, P .0031). The expression of CXCR2 but not CXCR1 on neutrophils and monocytes correlated negatively with the levels of interleukin-8 and myeloperoxidase.

CONCLUSIONS: After cardiopulmonary bypass, impairment of cardiovascular and respiratory function correlated with the levels of interleukin-6 and interleukin-8 as mediators of an inflammatory response. The negative correlation of CXCR2 expression with interleukin-8 and myeloperoxidase indicates that myeloid cells were stimulated by CXC chemokines with Glu-Leu-Arg (ELR) motif and thereby contributed to tissue damage, leading to impairment of cardiovascular and respiratory function.