Increased airway mucins after cardiopulmonary bypass associated with postoperative respiratory complications in children

Autor: Gianni D Angelini, Heather P Duncan, Hajime Imura, Anthony P. Corfield, Massimo Caputo, A.John Henderson, Neil Myerscough, Andrew R. Wolf
Rok vydání: 2004
Předmět:
Time Factors
Statistics as Topic
030204 cardiovascular system & hematology
Severity of Illness Index
law.invention
Postoperative Complications
0302 clinical medicine
law
Postoperative Period
Respiratory system
Child
Respiratory Distress Syndrome
0303 health sciences
Cardiopulmonary Bypass
Infant Welfare
respiratory system
3. Good health
Trachea
Treatment Outcome
medicine.anatomical_structure
Child
Preschool
Anesthesia
Circulatory system
Cardiology and Cardiovascular Medicine
Bronchoalveolar Lavage Fluid
Heart Defects
Congenital
Pulmonary and Respiratory Medicine
Child Welfare
Respiratory Mucosa
Lung injury
03 medical and health sciences
Cardiopulmonary bypass
medicine
Humans
Cardiac Surgical Procedures
Glycoproteins
030304 developmental biology
business.industry
Mucin
Mucins
Infant
United Kingdom
Oxygen
Surgery
Airway
business
Complication
Biomarkers
Respiratory tract
Zdroj: The Journal of Thoracic and Cardiovascular Surgery. 127:963-969
ISSN: 0022-5223
DOI: 10.1016/j.jtcvs.2003.07.034
Popis: ObjectiveAirway mucins may play an important role in the mechanism of respiratory complications after cardiopulmonary bypass in infants and children. Our aim was to measure airway mucin levels before and after cardiopulmonary bypass and to determine whether changes in mucin levels were associated with the development of respiratory complications.MethodsAirway glycoprotein and mucins (MUC5AC, MUC5B, and MUC2) in serial small-volume airway lavage samples from 39 young children who underwent cardiac operations with cardiopulmonary bypass were measured by slot-blot assay with specific antimucin peptide antibodies. The relationship between mucin changes and post–cardiopulmonary bypass respiratory complications was investigated. Airway lavage samples were also collected from 11 children before and after operation without cardiopulmonary bypass, and changes in mucin levels were compared with those in subjects who underwent cardiopulmonary bypass. Airway lavage sample DNA was also measured to investigate the relationship between mucin changes and lung injury.ResultsGlycoprotein, MUC5AC, and MUC5B levels were significantly increased after cardiopulmonary bypass (P < .001) whereas MUC2 level was not. Children with respiratory complications showed significantly higher glycoprotein and MUC5AC levels than did children without respiratory complications before and after cardiopulmonary bypass (P < .05). Increase of total mucin (MUC5AC, MUC5B, and MUC2) during cardiopulmonary bypass showed positive correlation with DNA increase during cardiopulmonary bypass (r = 0.73), Paco2 (r = 0.62) and alveolar-arterial oxygen difference (r = 0.55) immediately after cardiopulmonary bypass. Increase of total mucin was associated with postoperative respiratory complications and their severity. There were no significant changes detected in airway mucin during operations without cardiopulmonary bypass.ConclusionsAirway mucins were increased during cardiopulmonary bypass, and this increase was associated with markers of lung injury after cardiopulmonary bypass and with the development of postoperative respiratory complications.
Databáze: OpenAIRE
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