Postoperative Adiponectin Levels in Pediatric Patients Undergoing Open Heart Surgery

Abstract

Background. Adipose tissue is an important endocrine organ that secretes cytokines, including adiponectin, levels of which are negatively correlated with the severity of the inflammatory process. Aim. To assess the time course of adiponectin levels following open heart surgery with cardiopulmonary bypass and its correlation with early postoperative outcomes. Materials and Methods. Blood samples were obtained from 24 children undergoing cardiac surgery and analyzed for adiponectin, C-reactive protein, and other inflammatory markers. Results. Baseline adiponectin levels were negatively correlated with patients' preoperative weight and age. Postoperative adiponectin levels decreased compared to baseline (P = 0.01) and correlated negatively with duration of cardiopulmonary bypass (r = −0.438, P = 0.037), length of stay in the pediatric intensive care unit (r = −0.457, P = 0.025), and the inotropic score (r = −0.471, P = 0.02). Adiponectin levels were positively correlated with sVCAM 1 levels; however, there was no correlation between adiponectin levels and sP selectin, tPA, MCP1, and sCD40. Conclusions. The inflammatory response after open heart surgery with cardiopulmonary bypass is associated with a reduction in adiponectin levels. Prolonged or more complicated surgery induced a more substantial inflammatory process characterized by a significant reduction in adiponectin levels over time and a delayed return to baseline levels.

Circulating S100B and Adiponectin in Children Who Underwent Open Heart Surgery and Cardiopulmonary Bypass

“…The finding of ADN trend in the perioperative period is not surprising and fits, in part, previous observations in pediatric patients where decreased ADN levels have been reported [ 27 ]. The discrepancies are several and reside in the number, timing, and the length of the monitoring time-points and in the different CPB management (mild versus moderate hypothermia).…”

“…The discrepancies are several and reside in the number, timing, and the length of the monitoring time-points and in the different CPB management (mild versus moderate hypothermia). In this setting, hypothermia is known to activate an exaggerated release of proinflammatory cytokines and of endogenous cortisol that may be responsible of decreased ADN transcription and blood levels [ 27 , 30 , 31 ]. Anyway, further investigations comparing ADN pattern under different CPB management such as mild versus moderate/deep hypothermia are so justified.…”

“…Therefore, the objective of this current study was to determine, in CHD newborns, if adipose tissue sources contribute significantly to serum levels of S100B by means of the longitudinal measurement of adiponectin (ADN), the most abundant adipose-derived protein in humans [ 27 ] and S100B at different perioperative time-points.…”