interleukin-8 and Heart-Septal-Defects--Ventricular

To investigate the influence of lidocaine on systemic inflammation in the perioperative ventricular septal defect (VSD).. Twenty patients, scheduled for ventricular septal defect were randomly divided into 2 groups: lidocaine and control groups. Before rebeat lidocaine 1 mg/kg was given. The venous blood samples were obtained from the central venous at the following points: after induction of anesthesia and before cardiopulmonary bypass(CPB,T1),1 h after CPB(T2),2 h after CPB(T3), and 4 h after CPB(T4). IL-6 and IL-8 were determined by radio-immunoassay.. Compared with those at T1, the levels of white blood cells,polymorphonuclear neutrophils,IL-6 and IL-8 increased significantly from T2 to T4 in both groups. IL-6 and IL-8 levels reached the peak at T2. Compared with those in control groups, IL-6 level decreased obviously in lidocaine group from T2 to T4, but IL-8 level remained unchanged significantly.. Under CPB and VSD repair the systemic inflammation is obvious, reaches the peak 30 min after CPB and persists to 4 h after CPB. Perioperative administration of lidocaine is effective against the inflammation.

Topics: Adolescent; Cardiopulmonary Bypass; Child; Female; Heart Septal Defects, Ventricular; Humans; Inflammation; Inflammation Mediators; Interleukin-6; Interleukin-8; Lidocaine; Male; Perioperative Care; Radioimmunoassay; Treatment Outcome

To investigate the mechanism of perioperative lung injury in patients of ventricular septal defect (VSD) with severe pulmonary hypertension.. The thromboxane B(2) (TXB(2)), 6-keto-prostagladin F(1 alpha) (6-keto-PGF(1 alpha)), malonyldiadehyde (MDA), interleukin-6 (IL-6), and IL-8, and blood pressure, pulmonary arterial pressure (PAP) and total pulmonary pressure (TPR) in thirty-one patients of VSD, 16 cases without pulmonary hypertension and 15 cases with severe pulmonary hypertension, were examined after anesthesia (AA), over extracorporeal circulation (OEC), and 1 hour (PEC1), 6 hours (PEC6), 24 hours (PEC24), 48 hours (PEC48), and 72 hours (PEC72) post extracorporeal circulation. The respiratory index (RI) and ratio of 6-keto-PGF(1alpha) and TXB(2) (P/T) were calculated. Before and after extracorporeal circulation, pulmonary tissues were taken to be examined by light microscopy and electron microscopy.. In the cases with severe pulmonary hypertension the P/T was 0.81 +/- 0.26 after anesthesia, then decreased 0.65 +/- 0.28 over extracorporeal circulation, and reached its lowest value (0.51 +/- 0.32) 1 hour post extracorporeal circulation. MDA was 2.4 micromol/L +/- 0.6 micromol/L after anesthesia, then increased, was 7.0 micromol/L +/- 1.7 micromol/L OEC, and reached its peak value (7.3 micromol/L +/- 0.9 micromol/L) PEC1. IL-6 was 0.27 ng/L +/- 0.12 ng/L after anesthesia, then increased, and reached its peak value (0.50 ng/L +/- 0.19 ng/L) PEC1. IL-8 was 7.5 ng/L +/- 1.5 ng/L after anesthesia, then increased, was 152 ng/L +/- 50 ng/L PEC1, and reached its peak (183 ng/L +/- 63 ng/L) PEC6. TXB(2) was 251 ng/L +/- 44 ng/L after anesthesia, then increased, and reached its peak (967 ng/L +/- 145 ng/L) at PEC1. The PAP was 72.1 +/- 18.8 mm Hg after anesthesia, 55 mm Hg +/- 15.3 mm Hg OPC, and 7.4 +/- 2.1 at PEC1, then decreased, and was 53 mm Hg +/- 15 mm Hg at PEC72. The total pulmonary resistance (TPR) was 10.6 +/- 2.9 mm Hg x min(-1) x L(-1) after anesthesia, then increased, and reached its peak (15.0 +/- 3.9 mm Hg x min(-1) x L(-1) at PEC6. Respiratory index (RI) was 0.88 +/- 0.23, then increased, and reached its peak (2.35 +/- 0.72) at PEC6. TXB(2) and RI were positively correlated with pulmonary vascular resistance (gamma = 0.283, P < 0.05; gamma = 0.403, P < 0.05). RI was positively correlated with MDA (gamma = 0.403, P < 0.05). Morphologic studies revealed discontinuities in the endothelial cell lining of pulmonary capillaries, infiltration of inflammatory cells, plugging of pulmonary capillaries with neutrophils, and intraalveolar hemorrhage.. During the perioperative period, the pulmonary damage, which leads to pulmonary hypertensive crisis, is more severe among the cases of VSD with severe pulmonary hypertension than among the case without pulmonary hypertension.

Topics: Adolescent; Blood Pressure; Child; Extracorporeal Circulation; Female; Heart Septal Defects, Ventricular; Humans; Hypertension, Pulmonary; Interleukin-6; Interleukin-8; Lung Diseases; Lung Injury; Male; Malondialdehyde; Postoperative Complications; Pulmonary Artery; Thromboxane B2; Time Factors

The effect of ultrafiltration during cardiopulmonary bypass (CPB) was evaluated for correcting ventricular septal defects with associated pulmonary hypertension in patients less than 18 months old. Interleukin (IL)-6 and IL-8 concentrations in the blood, ultrafiltrate, and urine were measured. The blood IL-6 concentration increased to 128.4+/-20.2 pg/ml by the end of surgery, which is lower than the concentration seen in adult patients (273.1+/-48.2 pg/ml, p < 0.02). The blood IL-8 concentration was not significantly different than that of adults. The total amounts of excreted IL-6 in the ultrafiltrate and urine during CPB were 11.5+/-0.32 pg/kg and 0.32+/-0.07 pg/kg, respectively (p < 0.05). The total amounts of excreted IL-8 in the ultrafiltrate and urine were 4.64+/-0.69 pg/kg and 1.92+/-0.56 pg/kg, respectively (p < 0.05). No differences were seen in these values for excretion between children and adults. We conclude that ultrafiltration during CPB in pediatric patients is more effective in removing proinflammatory cytokines than in adults and more effective than renal filtration alone.

Topics: Cardiopulmonary Bypass; Cell Adhesion Molecules; Heart Septal Defects, Ventricular; Hemofiltration; Humans; Hypertension, Pulmonary; Infant; Interleukin-6; Interleukin-8; Water-Electrolyte Balance