Abstract
Although cardiopulmonary bypass (CPB) has been previously studied as risking infection and inflammatory responses, few studies evaluate the relationship of preoperative high total immunoglobulin E (tIgE) to outcomes in pediatric patients predisposed to atopy undergoing cardiac surgery with CPB. Serum tIgE, tumor necrosis factor-α (TNF-α), interleukin-10 (IL-10), IL-4, interferon-γ (IFN-γ), and T-helper type 1/2 (Th1/Th2) ratio were quantified in 104 pediatric patients who underwent surgical repair with CPB. Blood samples were obtained: before operation (T1), at the beginning (T2), and before the completion of CPB (T3), after protamine administration (T4), 4 h after CPB (T5), and on postoperative days 1 and 2 (T6, T7). Data on clinical outcomes were collected prospectively. Compared to 50 cases with normal tIgE, 54 cases with high tIgE were found to have higher TNF-α, IL-10, and IL-4 affected by CPB on the specific timepoints (pTNF-α < 0.001; pIL-10 = 0.035; pIL-4 = 0.001). TIgE levels shifted transiently towards Th2, which may be caused by high tIgE specific to T4. This resulted in the correlation between prolonged duration of mechanical ventilation (IL-4: r = 0.426, p = 0.015; Th1/Th2: r = -0.272, p = 0.043) in patients with high tIgE. A high preoperative tIgE level predisposes patients to an aggravated Th2 shift after protamine administration during CPB in association with increased risk of prolonged mechanical ventilation and medical intervention.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.