Skip to main content
Top
Published in: Pediatric Surgery International 1/2011

01-01-2011 | Original Article

Elevated inflammatory mediators and pulmonary hypertension after applying an extracorporeal circuit in a neonatal sepsis model

Authors: Mohamed Hamed Hussein, Ghada Abdel-Hamid Daoud, Takashi Hashimoto

Published in: Pediatric Surgery International | Issue 1/2011

Login to get access

Abstract

Purpose

We aimed to study the changes in cytokines, oxidative mediators, and pulmonary blood pressure in a neonatal sepsis model when applying an extracorporeal circuit (ECC).

Methods

Of 28 anesthetized and mechanically ventilated 3-day-old piglets, 14 underwent cecal ligation and perforation (CLP), of which 7 underwent ECC for 3 h from 3 to 6 h after CLP. The remaining 14 were sham, of which 7 underwent ECC. Serum interleukin (IL)-6, IL-10, tumor necrosis factor (TNF), interferon gamma (IFN-γ), total hydroperoxide (TH), nitric oxide metabolites (NOx), and mean pulmonary arterial blood pressure (mPAP)/mean arterial blood pressure (mABP) ratio were measured at pre-CLP and at 3, 6, and 9 h in the CLP groups, and continued in the sham groups at 12, 15, 18, and 24 h.

Results

The CLP group with ECCs compared to the CLP group without it showed higher levels of serum IL-6, IL-10, and NOx at 6 h and higher levels of serum TH at 6 and 9 h. The sham group with ECCs compared to the one without it showed higher levels of serum IL-6 and IL-10 at 12, 15, and 18 h, TH at 6 and 9 h, TNF at 6 h, and IFN-γ at 9 h. The mPAP/mABP ratios in the CLP group with ECCs were higher compared to the CLP group without it at 6 and 9 h.

Conclusion

Applying ECCs provoked a window of cytokines, free radicals elevation, and pulmonary hypertension which could be hazardous in critically ill newborns.
Literature
2.
go back to reference Nieman G, Searles B, Carney D, McCann U, Schiller H, Lutz C, Finck C, Gatto LA, Hodell M, Picone A (1999) Systemic inflammation induced by cardiopulmonary bypass: a review of pathogenesis and treatment. J Extra Corpor Technol 31(4):202–210PubMed Nieman G, Searles B, Carney D, McCann U, Schiller H, Lutz C, Finck C, Gatto LA, Hodell M, Picone A (1999) Systemic inflammation induced by cardiopulmonary bypass: a review of pathogenesis and treatment. J Extra Corpor Technol 31(4):202–210PubMed
3.
go back to reference Cooper JR Jr, Abrams J, Frazier OH, Radovancevic R, Radovancevic B, Bracey AW, Kindo MJ, Gregoric ID (2006) Fatal pulmonary microthrombi during surgical therapy for end-stage heart failure: possible association with antifibrinolytic therapy. J Thorac Cardiovasc Surg 131(5):963–968. doi:S0022-5223(06)00085-7[pii] CrossRefPubMed Cooper JR Jr, Abrams J, Frazier OH, Radovancevic R, Radovancevic B, Bracey AW, Kindo MJ, Gregoric ID (2006) Fatal pulmonary microthrombi during surgical therapy for end-stage heart failure: possible association with antifibrinolytic therapy. J Thorac Cardiovasc Surg 131(5):963–968. doi:S0022-5223(06)00085-7[pii] CrossRefPubMed
5.
go back to reference Kilbourn RG, Griffith OW (1992) Overproduction of nitric oxide in cytokine-mediated and septic shock. J Natl Cancer Inst 84(11):827–831CrossRefPubMed Kilbourn RG, Griffith OW (1992) Overproduction of nitric oxide in cytokine-mediated and septic shock. J Natl Cancer Inst 84(11):827–831CrossRefPubMed
6.
go back to reference Christen S, Finckh B, Lykkesfeldt J, Gessler P, Frese-Schaper M, Nielsen P, Schmid ER, Schmitt B (2005) Oxidative stress precedes peak systemic inflammatory response in pediatric patients undergoing cardiopulmonary bypass operation. Free Radic Biol Med 38(10):1323–1332. doi:S0891-5849(05)00034-1[pii] CrossRefPubMed Christen S, Finckh B, Lykkesfeldt J, Gessler P, Frese-Schaper M, Nielsen P, Schmid ER, Schmitt B (2005) Oxidative stress precedes peak systemic inflammatory response in pediatric patients undergoing cardiopulmonary bypass operation. Free Radic Biol Med 38(10):1323–1332. doi:S0891-5849(05)00034-1[pii] CrossRefPubMed
7.
go back to reference Hesse DG, Tracey KJ, Fong Y, Manogue KR, Palladino MA Jr, Cerami A, Shires GT, Lowry SF (1988) Cytokine appearance in human endotoxemia and primate bacteremia. Surg Gynecol Obstet 166(2):147–153PubMed Hesse DG, Tracey KJ, Fong Y, Manogue KR, Palladino MA Jr, Cerami A, Shires GT, Lowry SF (1988) Cytokine appearance in human endotoxemia and primate bacteremia. Surg Gynecol Obstet 166(2):147–153PubMed
10.
go back to reference Batra S, Kumar R, Seema, Kapoor AK, Ray G (2000) Alterations in antioxidant status during neonatal sepsis. Ann Trop Paediatr 20(1):27–33CrossRefPubMed Batra S, Kumar R, Seema, Kapoor AK, Ray G (2000) Alterations in antioxidant status during neonatal sepsis. Ann Trop Paediatr 20(1):27–33CrossRefPubMed
11.
go back to reference Buonocore G, Perrone S, Longini M, Terzuoli L, Bracci R (2000) Total hydroperoxide and advanced oxidation protein products in preterm hypoxic babies. Pediatr Res 47(2):221–224CrossRefPubMed Buonocore G, Perrone S, Longini M, Terzuoli L, Bracci R (2000) Total hydroperoxide and advanced oxidation protein products in preterm hypoxic babies. Pediatr Res 47(2):221–224CrossRefPubMed
13.
go back to reference Yang S, Cioffi WG, Bland KI, Chaudry IH, Wang P (1999) Differential alterations in systemic and regional oxygen delivery and consumption during the early and late stages of sepsis. J Trauma 47(4):706–712CrossRefPubMed Yang S, Cioffi WG, Bland KI, Chaudry IH, Wang P (1999) Differential alterations in systemic and regional oxygen delivery and consumption during the early and late stages of sepsis. J Trauma 47(4):706–712CrossRefPubMed
15.
go back to reference Hussein MH, Kato T, Sugiura T, Daoud GA, Suzuki S, Fukuda S, Sobajima H, Kato I, Togari H (2005) Effect of hemoperfusion using polymyxin B-immobilized fiber on IL-6, HMGB-1, and IFN gamma in a neonatal sepsis model. Pediatr Res 58(2):309–314. doi:01.PDR.0000169995.25333.F7[pii] CrossRefPubMed Hussein MH, Kato T, Sugiura T, Daoud GA, Suzuki S, Fukuda S, Sobajima H, Kato I, Togari H (2005) Effect of hemoperfusion using polymyxin B-immobilized fiber on IL-6, HMGB-1, and IFN gamma in a neonatal sepsis model. Pediatr Res 58(2):309–314. doi:01.​PDR.​0000169995.​25333.​F7[pii] CrossRefPubMed
16.
go back to reference Dohi K, Satoh K, Ohtaki H, Shioda S, Miyake Y, Shindo M, Aruga T (2005) Elevated plasma levels of bilirubin in patients with neurotrauma reflect its pathophysiological role in free radical scavenging. In Vivo 19(5):855–860PubMed Dohi K, Satoh K, Ohtaki H, Shioda S, Miyake Y, Shindo M, Aruga T (2005) Elevated plasma levels of bilirubin in patients with neurotrauma reflect its pathophysiological role in free radical scavenging. In Vivo 19(5):855–860PubMed
17.
go back to reference Toft P, Brix-Christensen V, Baech J, Krog J, Jorgensen HS, Tonnesen E, Petersen TK, Dagnaes-Hansen F (2002) Effect of hemodiafiltration and sepsis on chemotaxis of granulocytes and the release of IL-8 and IL-10. Acta Anaesthesiol Scand 46(2):138–144. doi:aas460203[pii] CrossRefPubMed Toft P, Brix-Christensen V, Baech J, Krog J, Jorgensen HS, Tonnesen E, Petersen TK, Dagnaes-Hansen F (2002) Effect of hemodiafiltration and sepsis on chemotaxis of granulocytes and the release of IL-8 and IL-10. Acta Anaesthesiol Scand 46(2):138–144. doi:aas460203[pii] CrossRefPubMed
18.
go back to reference Lyons A, Kelly JL, Rodrick ML, Mannick JA, Lederer JA (1997) Major injury induces increased production of interleukin-10 by cells of the immune system with a negative impact on resistance to infection. Ann Surg 226(4):450–458 discussion 458–460CrossRefPubMed Lyons A, Kelly JL, Rodrick ML, Mannick JA, Lederer JA (1997) Major injury induces increased production of interleukin-10 by cells of the immune system with a negative impact on resistance to infection. Ann Surg 226(4):450–458 discussion 458–460CrossRefPubMed
20.
go back to reference Nagarkatti M, Clary SR, Nagarkatti PS (1990) Characterization of tumor-infiltrating CD4+ T cells as Th1 cells based on lymphokine secretion and functional properties. J Immunol 144(12):4898–4905PubMed Nagarkatti M, Clary SR, Nagarkatti PS (1990) Characterization of tumor-infiltrating CD4+ T cells as Th1 cells based on lymphokine secretion and functional properties. J Immunol 144(12):4898–4905PubMed
22.
go back to reference Ochoa JB, Udekwu AO, Billiar TR, Curran RD, Cerra FB, Simmons RL, Peitzman AB (1991) Nitrogen oxide levels in patients after trauma and during sepsis. Ann Surg 214(5):621–626CrossRefPubMed Ochoa JB, Udekwu AO, Billiar TR, Curran RD, Cerra FB, Simmons RL, Peitzman AB (1991) Nitrogen oxide levels in patients after trauma and during sepsis. Ann Surg 214(5):621–626CrossRefPubMed
23.
go back to reference Figueras-Aloy J, Gomez L, Rodriguez-Miguelez JM, Jordan Y, Salvia MD, Jimenez W, Carbonell-Estrany X (2003) Plasma nitrite/nitrate and endothelin-1 concentrations in neonatal sepsis. Acta Paediatr 92(5):582–587CrossRefPubMed Figueras-Aloy J, Gomez L, Rodriguez-Miguelez JM, Jordan Y, Salvia MD, Jimenez W, Carbonell-Estrany X (2003) Plasma nitrite/nitrate and endothelin-1 concentrations in neonatal sepsis. Acta Paediatr 92(5):582–587CrossRefPubMed
24.
go back to reference Yamamoto S, Burman HP, O’Donnell CP, Cahill PA, Robotham JL (1997) Endothelin causes portal and pulmonary hypertension in porcine endotoxemic shock. Am J Physiol 272(3 pt 2):H1239–H1249PubMed Yamamoto S, Burman HP, O’Donnell CP, Cahill PA, Robotham JL (1997) Endothelin causes portal and pulmonary hypertension in porcine endotoxemic shock. Am J Physiol 272(3 pt 2):H1239–H1249PubMed
25.
go back to reference Silveira RC, Procianoy RS (1999) Evaluation of interleukin-6, tumour necrosis factor-alpha and interleukin-1beta for early diagnosis of neonatal sepsis. Acta Paediatr 88(6):647–650CrossRefPubMed Silveira RC, Procianoy RS (1999) Evaluation of interleukin-6, tumour necrosis factor-alpha and interleukin-1beta for early diagnosis of neonatal sepsis. Acta Paediatr 88(6):647–650CrossRefPubMed
26.
go back to reference Pollack MM, Fields AI, Ruttimann UE (1984) Sequential cardiopulmonary variables of infants and children in septic shock. Crit Care Med 12(7):554–559CrossRefPubMed Pollack MM, Fields AI, Ruttimann UE (1984) Sequential cardiopulmonary variables of infants and children in septic shock. Crit Care Med 12(7):554–559CrossRefPubMed
27.
go back to reference Haworth SG (2006) Pulmonary endothelium in the perinatal period. Pharmacol Rep 58(Suppl):153–164PubMed Haworth SG (2006) Pulmonary endothelium in the perinatal period. Pharmacol Rep 58(Suppl):153–164PubMed
28.
go back to reference Kumar A, Thota V, Dee L, Olson J, Uretz E, Parrillo JE (1996) Tumor necrosis factor alpha and interleukin 1beta are responsible for in vitro myocardial cell depression induced by human septic shock serum. J Exp Med 183(3):949–958CrossRefPubMed Kumar A, Thota V, Dee L, Olson J, Uretz E, Parrillo JE (1996) Tumor necrosis factor alpha and interleukin 1beta are responsible for in vitro myocardial cell depression induced by human septic shock serum. J Exp Med 183(3):949–958CrossRefPubMed
Metadata
Title
Elevated inflammatory mediators and pulmonary hypertension after applying an extracorporeal circuit in a neonatal sepsis model
Authors
Mohamed Hamed Hussein
Ghada Abdel-Hamid Daoud
Takashi Hashimoto
Publication date
01-01-2011
Publisher
Springer-Verlag
Published in
Pediatric Surgery International / Issue 1/2011
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI
https://doi.org/10.1007/s00383-010-2727-x

Other articles of this Issue 1/2011

Pediatric Surgery International 1/2011 Go to the issue