Changes in the levels of inflammatory markers after transthoracic device closure of ventricular septal defects in pediatric patients

Abstract

Background Transthoracic device closure of ventricular septal defect (VSD) is widely used in the clinic, especially in China. Changes in inflammatory marker levels after transthoracic device closure of VSD in pediatric patients have not been reported. Methods We retrospectively collected clinical data for 85 pediatric patients in our hospital from September 2017 to January 2018. The patients were divided into two groups according to treatment (device group vs. surgical group). The clinical and experimental data from the two groups were statistically analyzed. Results Clinical outcomes were good in all patients without any fatal complications. Similar increasing trends in inflammatory markers (white blood cell (WBC) count, procalcitonin (PCT), C-reactive protein (CRP), and interleukin-6 (IL-6)) were found in the two groups, both of which showed noticeable systemic inflammatory responses. In addition, no significant difference in the postoperative levels of inflammatory markers was observed between these two groups. Conclusions Although transthoracic device closure of VSD seems to be less traumatic and involves a quicker recovery, it also induces a systemic inflammatory response as measured by WBC count and PCT, CRP and IL-6 levels, and the altered trends in inflammatory markers were similar to those of conventional surgery under CPB.

C‐reactive protein and procalcitonin after congenital heart surgery utilizing cardiopulmonary bypass: When should we be worried?

“…A total of 21 studies were included in the pooled analyses 5,15–19,21–35 . Data were collected for the following timepoints: pre‐CPB, end of CPB, 1 h after CPB, POD 1, POD 2, POD 3, POD 4, and POD 5.…”

“…A total of 21 studies were included in the pooled analyses. 5,[15][16][17][18][19][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] Data were collected for the following timepoints: pre-CPB, end of CPB, 1 h after CPB, POD 1, POD 2, POD 3, POD 4, and POD 5. Figure 1 outlines the study search strategy while Table 1 provides an overview of included studies.…”

“…CRP is an acute-phase reactant synthesized in the liver in response to multiple inflammatory conditions, including infections. 10,16,26 Though, many studies have demonstrated routinely elevated PCT and CRP levels in neonates and young infants 24 hours after CHS with CPB, 16,26 this is the first pooled As previous studies also have shown, the measurement of PCT is better at diagnosing bacterial infections than CRP. A meta-analysis by Yu et al 39 which included 22 studies showed that PCT had better accuracy that CRP in the diagnosis of late onset neonatal sepsis.…”

“…PCT is a prohormone of calcitonin, produced in the C‐cells of the thyroid gland and undetectable under normal circumstances. CRP is an acute‐phase reactant synthesized in the liver in response to multiple inflammatory conditions, including infections 10,16,26 . Though, many studies have demonstrated routinely elevated PCT and CRP levels in neonates and young infants 24 hours after CHS with CPB, 16,26 this is the first pooled analysis showing that both PCT and CRP levels rise in all patients after CHS with CPB regardless of the presence of infection.…”

Prophylactic use of levosimendan in pediatric patients undergoing cardiac surgery: a prospective randomized controlled trial

“…The 2019 report of cardiovascular disease in China indicated that there are roughly 2 million individuals suffering from congenital heart disease (CHD), with over 110,000 pediatric patients undergoing surgical treatment for this condition annually. Given that pediatric patients have a very physiologically limited contractile reserve, they are at a high risk of marked reductions in ventricular performance during cardiac surgery as a consequence of factors such as hypoxia, acidosis, ischemia-reperfusion injury, neurohormone-mediated activation, or systemic inflammation [1, 2]. These risk factors can lead to 3~14% of patients that undergo surgery with cardiopulmonary bypass (CPB) suffering from heart failure or low cardiac output syndrome (LCOS), while these rates can be as high as 25% in pediatric patients and are linked to a 15-fold rise in morbidity and mortality following surgical treatment of CHD [3–5].…”