Document Detail


Capillary leak syndrome in children who undergo cardiopulmonary bypass: clinical outcome in comparison with complement activation and C1 inhibitor.
MedLine Citation:
PMID:  11280634     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Capillary leak syndrome (CLS) is associated with significantly increased morbidity and occurs after cardiopulmonary bypass in children with congenital heart disease. We investigated the early clinical parameters that predict the development of CLS and examined the relationship between the presence of CLS and complement and contact activation and C1 esterase inhibitor (C1-INH) during and after bypass. DESIGN: In this prospective study we took serial serological measurements of the complement and contact system and C1-INH in a cohort of 27 infants before, during, and up to 96 h after open-heart surgery. RESULTS: Complement and contact activation and a decrease in C1-INH were measured in all infants during and after CPB. Ten infants developed CLS postoperatively. Younger age and longer bypass time were strongly correlated to the development of CLS. No relationship was found between the degree of hypothermia, weight, gender, or cross-clamp time. C1-INH concentration and activity were lower peri- and postoperatively in the CLS group. Infants with CLS had a more pronounced postoperative increase in the C5a and C3a levels, higher postoperative level of factor XIIa, and lower prekallikrein activity than those without CLS. CONCLUSION: Contact and complement activation occurs during cardiopulmonary bypass and contributes to CLS more frequently in infants of a younger age and with a prolonged bypass time. This activation and decrease in C1-INH was strongly expressed in the CLS group, and therefore early substitution of C1-INH may prevent CLS after open-heart surgery in high-risk infants.
Authors:
B Stiller; J Sonntag; I Dähnert; V Alexi-Meskishvili; R Hetzer; T Fischer; P E Lange
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Intensive care medicine     Volume:  27     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  2001 Jan 
Date Detail:
Created Date:  2001-03-30     Completed Date:  2001-06-28     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  193-200     Citation Subset:  IM    
Affiliation:
Department of Pediatric Cardiology, Deutsches Herzzentrum Berlin, Germany. stiller@dhzb.de
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MeSH Terms
Descriptor/Qualifier:
Capillary Leak Syndrome / blood*,  etiology,  physiopathology
Cardiopulmonary Bypass*
Complement Activation*
Complement C1 Inactivator Proteins / metabolism*
Female
Heart Defects, Congenital / surgery*
Humans
Infant
Infant, Newborn
Male
Postoperative Complications*
Prospective Studies
Time Factors
Chemical
Reg. No./Substance:
0/Complement C1 Inactivator Proteins

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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