Verlauf der PCT-Blutkonzentrationen während und nach Herzoperationen mit extrakorporaler Zirkulation bei Kindern

The extracorporal circulation (EKK) induces in adults as in children a systemic inflammatory reaction. We examined a total of 20 infants at an age from 3 to 13 months with a ventricular septal defect (VSD), complete atrioventricular septal defect (AVSD) or a Fallot’ schen tetralogy. We divided these patients into patients with hypoxemia along with Fallot’ sche tetralogy and patients with cardiac insufficiency caused either by VSD or AVSD. Both groups showed a comparable average age and showed no significant difference in the duration of the EKK, arterial cuff closure and the circulatory shutdown. Before, during and after the surgical intervention with EKK we examined PCT, CRP, leukocyte count and interleukin IL-6, IL-8 and IL-10 levels in the plasma of the children. Our results show that heart operations with EKK lead to a systemic inflammatory reaction with leukocyte activation, cytokine synthesis and induction of CRP and PCT. In comparison to CRP PCT shows an earlier increase that lasts for only a short duration. Interestingly, hypoxemic patients showed higher IL-6 and PCT values as compared to patients with a cardiac insufficiency. Therefore, a stronger inflammatory reaction seems to take place in these hypoxemic patients. A correlation between PCT concentrations and post surgical course could not be ascertained. To sum up, cardiac surgery with EKK leads to a moderate PCT rise with a maximum during the first post surgical day. Causally, the increase of inflammatoric cytokines after EKK as well as a release of endotoxins from the ischemic organs in the blood circulation can play a decisive role. According to these results, PCT can not serve as a prognostic marker for children undergoing heart surgery. In further clinical and experimental studies the place of PCT synthesis as well as the cells which synthesise PCT after EKK must be elucidated.

Grantor dc:publisher

Publikationsserver der RWTH Aachen University

Year dc:date

2007

Author dc:creator

• Babilas, Kirsten

Contributors dc:contributor

• Seghaye, Marie-Christine

• info:eu-repo/classification/ddc/610
• Procalcitonin
• Interleukine
• C-reaktives Protein
• Leukozyt
• Entzündung
• Medizin
• C-reactive protein
• leucocyte
• inflammation

Statement dc:rights

• info:eu-repo/semantics/openAccess

Language dc:language

ger

Identifier

https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-114569%22

OAI record oai:identifier

https://publications.rwth-aachen.de/oai2d?verb=GetRecord&metadataPrefix=oai_dc&identifier=oai%3Apublications.rwth-aachen.de%3A52337