| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
The Journal of Thoracic and Cardiovascular Surgery, Vol 95, 842-849, Copyright © 1988 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
WJ Greeley, GA Bushman, DL Kong, HN Oldham and MB Peterson
Cardiopulmonary bypass in children with congenital heart disease is
associated with significant morbidity manifested by increased complement
degradation products, heightened pulmonary vascular activity, and
coagulopathy. In adults with cardiac disease, the prostaglandins
(eicosanoids) have been shown to contribute to the pathophysiologic
response to extracorporeal circulation. This study assessed the effect of
cardiopulmonary bypass in infants and children on two potent eicosanoids:
thromboxane, a vasoconstrictor and platelet aggregating agent, and
prostacyclin, a vasodilator and platelet disaggregating agent. The
biochemical profiles of thromboxane and prostacyclin were evaluated in
temporal relationship to selected parameters of platelet loss and pulmonary
vascular hemodynamics during and after cardiopulmonary bypass. Twenty-one
children, aged 3 days to 9 years, with congenital heart defects who were
undergoing repair with cardiopulmonary bypass were studied. Nine pediatric
patients undergoing palliative heart operations with no cardiopulmonary
bypass served as the control group. In the group having cardiopulmonary
bypass, the thromboxane concentration significantly increased during bypass
(195 +/- 10 to 910 +/- 240 pg/ml, +/- standard error of the mean, p less
than 0.005), whereas the control group demonstrated no significant change
in thromboxane concentration. The highest thromboxane values were seen in
the youngest patients (p less than 0.002). There was no significant
correlation between thromboxane changes with alterations in pulmonary
vascular resistance, platelet loss, duration of cardiopulmonary bypass or
aortic cross-clamping. Prostacyclin levels rose significantly in both the
bypass group (100 +/- 20 to 570 +/- 80 pg/ml, p less than 0.01) and in the
control group (109 +/- 44 to 589 +/- 222 pg/ml, p less than 0.01), which
apparently is due to surgical manipulation of vascular endothelium. These
data show that eicosanoid production is significantly altered in children
during cardiopulmonary bypass. Although thromboxane, a potent
vasoconstrictor, is produced in significant amounts during and after
cardiopulmonary bypass, our data show that thromboxane does not directly
mediate changes in pulmonary artery hypertension and is not quantitatively
related to platelet loss during pediatric cardiovascular operations.
ARTICLES
Effects of cardiopulmonary bypass on eicosanoid metabolism during pediatric cardiovascular surgery
Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710.
This article has been cited by other articles:
|
|
 |
|
  D. J. Kozik and J. S. Tweddell Characterizing the Inflammatory Response to Cardiopulmonary Bypass in Children Ann. Thorac. Surg., June 1, 2006; 81(6): S2347 - S2354. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Z. Xia, J. Gu, D. M. Ansley, F. Xia, and J. Yu Antioxidant therapy with Salvia miltiorrhiza decreases plasma endothelin-1 and thromboxane B2 after cardiopulmonary bypass in patients with congenital heart disease J. Thorac. Cardiovasc. Surg., November 1, 2003; 126(5): 1404 - 1410. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. M. Pearl, P. B. Manning, J. L. McNamara, M. M. Saucier, and D. W. Thomas Effect of modified ultrafiltration on plasma thromboxane B2, leukotriene B4, and endothelin-1 in infants undergoing cardiopulmonary bypass Ann. Thorac. Surg., October 1, 1999; 68(4): 1369 - 1375. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Guay and J.-F. Hardy Invited commentary Ann. Thorac. Surg., September 1, 1998; 66(3): 875 - 876. [Full Text] [PDF]
|
|
|
|
|
|
A. Serraf, M. Robotin, N. Bonnet, H. Detruit, B. Baudet, M. G. Mazmanian, P. Herve, and C. Planche ALTERATION OF THE NEONATAL PULMONARY PHYSIOLOGY AFTER TOTAL CARDIOPULMONARY BYPASS J. Thorac. Cardiovasc. Surg., December 1, 1997; 114(6): 1061 - 1069. [Abstract] [Full Text]
|
|
|
|
 |
|
 M G Macey, D A McCarthy, U H Trivedi, G E Venn, D J Chambers, and K A Brown Neutrophil adhesion molecule expression during cardiopulmonary bypass: a comparative study of roller and centrifugal pumps Perfusion, September 1, 1997; 12(5): 293 - 301. [Abstract] [PDF]
|
|
|
|
|
|
V. M. Reddy, J. R. Liddicoat, J. R. Klein, D. B. McElhinney, R. K. Wampler, and F. L. Hanley Fetal Cardiac Bypass Using an In-Line Axial Flow Pump to Minimize Extracorporeal Surface and Avoid Priming Volume Ann. Thorac. Surg., August 1, 1996; 62(2): 393 - 400. [Abstract] [Full Text]
|
|
|
|
|
|
M. C. Deng, B. Dasch, M. Erren, T. Mollhoff, and H. H. Scheld Impact of Left Ventricular Dysfunction on Cytokines, Hemodynamics, and Outcome in Bypass Grafting Ann. Thorac. Surg., July 1, 1996; 62(1): 184 - 190. [Abstract] [Full Text]
|
|
|
|
|
|
K. Morita, K. Ihnken, G. D. Buckberg, M. P. Sherman, and L. J. Ignarro Pulmonary Vasoconstriction Due to Impaired Nitric Oxide Production After Cardiopulmonary Bypass Ann. Thorac. Surg., June 1, 1996; 61(6): 1775 - 1780. [Abstract] [Full Text]
|
|
|
|
|
|
F. Nicolas, J.-P. Daniel, J. Bruniaux, A. Serraf, F. Lacour-Gayet, and C. Planche Conventional cardiopulmonary bypass in neonates. A physiological approach -10 years of experience at Marie-Lannelongue Hospital Perfusion, January 1, 1994; 9(1): 41 - 48. [Abstract] [PDF]
|
|
|
|
|
|
F. H Kern, W. J Greeley, and R. U. Duke The effects of bypass on the developing brain Perfusion, January 1, 1993; 8(1): 49 - 54. [PDF]
|
|
|
|
|
|
H. Komai and S. G Haworth The effect of cardiopulmonary bypass on the lung: the injured pulmonary vascular endothelium Perfusion, January 1, 1993; 8(1): 55 - 62. [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
