1. Influence of the type of congenital heart defects on epithelial lining fluid composition in infants undergoing cardiac surgery with cardiopulmonary bypass
- Author
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Simonato, M, Baritussio, A, Carnielli, Vp, Vedovelli, L, Falasco, G, Salvagno, M, Padalino, M, Cogo, P., and Vedovelli, Luca
- Subjects
Heart Septal Defects, Ventricular ,Male ,Pulmonary Circulation ,Heart disease ,Transposition of Great Vessels ,030204 cardiovascular system & hematology ,Pediatrics ,Epithelium ,Hypoplastic left heart syndrome ,law.invention ,0302 clinical medicine ,law ,Hypoplastic Left Heart Syndrome ,Postoperative Period ,Child ,Lung ,Phospholipids ,Tetralogy of Fallot ,Cardiopulmonary Bypass ,Lung Injury ,respiratory system ,Perinatology and Child Health ,Cardiac surgery ,Trachea ,medicine.anatomical_structure ,Great arteries ,Models, Animal ,Cardiology ,Female ,Heart Defects, Congenital ,medicine.medical_specialty ,Heart Ventricles ,Lung injury ,03 medical and health sciences ,Surface-Active Agents ,Internal medicine ,Albumins ,medicine ,Cardiopulmonary bypass ,Animals ,Humans ,Cardiac Surgical Procedures ,Peroxidase ,business.industry ,Heparin ,Pulmonary Gas Exchange ,Hemodynamics ,Infant, Newborn ,Infant ,Pulmonary Surfactants ,medicine.disease ,Pulmonary Alveoli ,030228 respiratory system ,Pediatrics, Perinatology and Child Health ,business - Abstract
BackgroundIn children with congenital heart disease (CHD), altered pulmonary circulation compromises gas exchange. Moreover, pulmonary dysfunction is a complication of cardiac surgery with cardiopulmonary bypass (CPB). No data are available on the effect of different CHDs on lung injury. The aim of this study was to analyze epithelial lining fluid (ELF) surfactant composition in children with CHD.MethodsTracheal aspirates (TAs) from 72 CHD children (age 2.9 (0.4-5.7) months) were obtained before and after CPB. We measured ELF phospholipids, surfactant proteins A and B (SP-A, SP-B), albumin, and myeloperoxidase activity. TAs from 12 infants (age 1.0 (0.9-2.9) months) with normal heart/lung served as controls.ResultsHeart defects were transposition of great arteries (19), tetralogy of Fallot (TOF, 20), atrial/ventricular septal defect (ASD/VSD, 22), and hypoplastic left heart syndrome (11). Increased levels of ELF SP-B were found in all defects, increased myeloperoxidase activity in all except the TOF, and increased levels of ELF albumin and SP-A only in ASD/VSD patients. Postoperatively, ELF findings remained unchanged except for a further increase in myeloperoxidase activity.ConclusionELF composition has distinctive patterns in different CHD. We speculate that a better knowledge of the ELF biochemical changes may help to prevent respiratory complications. more...
- Published
- 2017