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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: OBJECTIVE, DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, MEASUREMENTS AND MAIN RESULTS. Meshes: Cardiopulmonary Bypass, Child, Preschool, Cohort Studies, E-Selectin, Enzyme-Linked Immunosorbent Assay, Female, Heart Defects, Congenital, Humans, Infant, Male, Postoperative Complications, Prognosis, Prospective Studies, Sepsis.
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Plasma-soluble E-selectin after cardiopulmonary bypass in children: is it a marker of the postoperative course? Context: To investigate the relationship and possible role of soluble adhesion molecule E-selectin in the postoperative course in children undergoing cardiopulmonary bypass (CPB). Prospective cohort study. Pediatric intensive care unit of a university hospital. Thirteen children who were candidates for cardiac surgery. None. Serial blood samples of 13 CPB patients were collected from the arterial catheter or from the bypass circuits preoperatively; on initiation of CPB; on termination of CPB; and 1, 2, 4, 8, 12, 18, 24, and 48 hours postoperatively. Plasma was recovered immediately, aliquoted, and frozen at -70 degrees C until use. Circulating soluble selectin molecules were measured with a sandwich enzyme-linked immunosorbent assay technique. There were significant changes in plasma levels of soluble E-selectins in patients after CPB, and these levels were associated with patient characteristics, operative variables, and postoperative course. Soluble E-selectin correlated significantly with inotropic support and the use of anti-inflammatory drugs. There was a significant association between the development of postoperative sepsis and soluble E-selectin levels. No correlation was found between soluble E-selectins and duration of CPB, aortic cross-clamping, or hemodynamic variables, including heart rate and mean systemic arterial pressure.
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These results suggest a relationship between CPB-induced mediators and early and late clinical effects. Although the mechanism for the increase of soluble E-selectin remains to be elucidated, the upregulation of soluble E-selectin indicates neutrophil activation, and its inhibition may represent a target for reducing the inflammatory response associated with CPB.