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Molecular and Cellular Pediatrics
Published in: Molecular and Cellular Pediatrics 1/2022

Open Access 01-12-2022 | Heart Surgery | Research

Uni-ventricular palliation vs. bi-ventricular repair: differential inflammatory response

Authors: Matthias Sigler, Hatem Rouatbi, Jaime Vazquez-Jimenez, Marie-Christine Seghaye

Published in: Molecular and Cellular Pediatrics | Issue 1/2022

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Abstract

Background

To examine whether uni-ventricular palliation (UVP) and bi-ventricular repair (BVR) result in a different pattern of systemic inflammatory response to pediatric cardiac surgery with extra-corporeal circulation (ECC).

Methods

In 20 children (median age 39.5 months) undergoing either UVP (n = 12) or BVR (n = 8), plasma levels of the inflammatory cytokines TNF-α, IL-6, IL-10, and IL-12 and of procalcitonin (PCT), were measured before, during and after open cardiac surgery up to postoperative day (POD) 10.

Results

Epidemiologic, operative- and outcome variables were similar in both groups but post-operative central venous pressure that was higher in UVP. In the whole cohort, the inflammatory response was characterized by an early important, significant and parallel increase of IL-6 and IL-10 that reached their peak values either at the end of ECC (IL-10) or 4 h postoperatively (IL-6), respectively and by a significant and parallel decrease of TNF-α and IL-12 levels after connection to ECC, followed by a bi-phasic significant increase with a first peak 4 h after ECC and a second at POD 10, respectively. Patients after UVP showed a shift of the cytokine balance with lower IL-6- (p = 0.01) after connection to ECC, lower early post-operative TNF-α - (p = 0.02) and IL-12- (p = 0.04) concentrations and lower TNF-α/IL-10-ratio (p = 0.03) as compared with patients with BVR. Levels of PCT were similar in both groups.

Conclusions

UVP is associated with an anti-inflammatory shift of the inflammatory response to cardiac surgery that might be related to the particular hemodynamic situation of patients with UVP.
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Metadata
Title
Uni-ventricular palliation vs. bi-ventricular repair: differential inflammatory response
Authors
Matthias Sigler
Hatem Rouatbi
Jaime Vazquez-Jimenez
Marie-Christine Seghaye
Publication date
01-12-2022
Publisher
Springer International Publishing
Published in
Molecular and Cellular Pediatrics / Issue 1/2022
Electronic ISSN: 2194-7791
DOI
https://doi.org/10.1186/s40348-022-00138-y

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