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Adrenomedullin Alterations Related to Cardiopulmonary, by-pass in Infants with Low Cardiac Output Syndrome.
MedLine Citation:
PMID:  22881718     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Abstract Background: Low cardiac output syndrome (LCOS) remains a major perioperative complications in infants subjected to open heart surgery with cardiopulmonary by-pass (CPB). The present study investigated whether perioperative blood assessment of a potent vasoactive peptide namely adrenomedullin (AM) can predict the risk of LCOS. Methods: We measured AM levels in 48 patients (LCOS: n=9; controls: n=39) undergone to open heart surgery with CPB at five predetermined timepoints before, during and after the surgery. Clinical, laboratory and perioperative data were analyzed by a multiple logistic regression model. Results: AM significantly decreased (P<0.01) during and after the surgical procedure exhibiting a dip at the end of the CPB. Multivariable analysis demonstrated significant correlations among LCOS, AM measured at the end of CPB (P<0.001), and cooling duration (P<0.05). AM at 27 pg/L cut-off achieved a sensitivity of 100% and a specificity of 64.1%, whilst cooling at 11 minutes cut-off combined a sensitivity of 55.6% and a specificity of 92.3% for LCOS prediction. Conclusions: This study suggests that AM can constitute, alone or combined with standard parameters, a promising predictor of LCOS in infants subjected to open heart surgery with CPB.
Authors:
Raul Abella; Angela Satriano; Alessandro Frigiola; Alessandro Varrica; Antonio Dw Gavilanes; Luc J Zimmermann; Hans Js Vles; Pasquale Florio; Maria Grazia Calevo; Diego Gazzolo
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-13
Journal Detail:
Title:  The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians     Volume:  -     ISSN:  1476-4954     ISO Abbreviation:  J. Matern. Fetal. Neonatal. Med.     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Dept. of Pediatric Cardiac Surgery IRCCS San Donato Milanese Hospital, San Donato Milanese, Italy.
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