Soluble P-selectin and the postoperative course following cardiopulmonary bypass in children

Background: Cytokine-inducible leucocyte-endothelial adhesion molecules wer e shown to affect the postoperative inflammatory response following cardiop ulmonary bypass (CPB). Soluble P-selectin (sP-selectin) is one of these mol ecules. We investigated the correlation between plasma sP-selectin levels a nd the intra- and postoperative course in children undergoing CPB. Methods: Serial blood samples of 13 patients were collected preoperatively upon initiation of CPB and seven times postoperatively. Plasma was recovere d immediately and frozen at - 70 degreesC until use. Circulating soluble se lectin molecules were measured with a sandwich enzyme-linked immunoabsorben t assay technique. Results: The significant post-CPB changes in sP-selectins plasma levels wer e associated with patient characteristics, operative variables and postoper ative course. sP-selectin levels correlated significantly with surgery time , aortic cross-clamping time and inotropic support, as well as with the pos toperative Pediatric Risk of Mortality score, hypotension and tachycardia. Conclusions: A relation between CPB-induced mediators and both early and la te clinical effects is suggested. The up-regulation and expression of sP-se lectin indicate neutrophil activation as a possible mechanism for the incre ase, and inhibiting it may reduce the inflammatory response associated with CPB.