Children with single ventricle heart disease have a greater increase in sRAGE after cardiopulmonary bypass.

Autor:	Brooks BA; Division of Pediatric Critical Care Medicine, Mattel Children's Hospital, University of California Los Angeles, Los Angeles, CA, USA.; Division of Critical Care Medicine, Children's National Hospital, Washington, DC, USA., Sinha P; Department of Pediatric Cardiac Surgery, M Health Fairview University of Minnesota, Minneapolis MN, USA.; Division of Cardiovascular Surgery, Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, DC, USA., Staffa SJ; Department of Anesthesiology, Critical Care and Pain Medicine, Harvard University, Boston Children's Hospital, Boston, MA, USA., Jacobs MB; Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, CA, USA.; Division of Biostatistics and Study Methodology, Children's National Hospital, Washington, DC, USA., Freishtat RJ; Center for Genetic Medicine Research, Children's National Hospital, Washington, DC, USA.; Departments of Pediatrics, Emergency Medicine, and Genomics & Precision Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, USA., Patregnani JT; Division of Pediatric Critical Care Medicine, Maine Medical Center, Tufts University School of Medicine, Barbara Bush Children's Hospital, Portland, ME, USA.; Division of Pediatric Cardiac Critical Care, Children's National Hospital, George Washington University School of Medicine, Washington, DC, USA.
Jazyk:	angličtina
Zdroj:	Perfusion [Perfusion] 2024 Oct; Vol. 39 (7), pp. 1314-1322. Date of Electronic Publication: 2023 Jul 19.
DOI:	10.1177/02676591231189357
Abstrakt:	Introduction: Reducing cardiopulmonary bypass (CPB) induced inflammatory injury is a potentially important strategy for children undergoing multiple operations for single ventricle palliation. We sought to characterize the soluble receptor for advanced glycation end products (sRAGE), a protein involved in acute lung injury and inflammation, in pediatric patients with congenital heart disease and hypothesized that patients undergoing single ventricle palliation would have higher levels of sRAGE following bypass than those with biventricular physiologies. Methods: This was a prospective, observational study of children undergoing CPB. Plasma samples were obtained before and after bypass. sRAGE levels were measured and compared between those with biventricular and single ventricle heart disease using descriptive statistics and multivariate analysis for risk factors for lung injury. Results: sRAGE levels were measured in 40 patients: 19 with biventricular and 21 with single ventricle heart disease. Children undergoing single ventricle palliation had a higher factor and percent increase in sRAGE levels when compared to patients with biventricular circulations (4.6 vs. 2.4, p = 0.002) and (364% vs. 181%, p = 0.014). The factor increase in sRAGE inversely correlated with the patient's preoperative oxygen saturation (Pearson correlation (r) = -0.43, p = 0.005) and was positively associated with red blood cell transfusion (coefficient = 0.011; 95% CI: 0.004, 0.017; p = 0.001). Conclusions: Children with single ventricle physiology have greater increase in sRAGE following CPB as compared to children undergoing biventricular repair. Larger studies delineating the role of sRAGE in children undergoing single ventricle palliation may be beneficial in understanding how to prevent complications in this high-risk population. Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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