Clinical variables and pro-inflammatory activation in paediatric heart surgery

Objectives-The first aim was to analyse the role of preoperative characteri stics and perioperative variables in predicting the inflammatory response d uring and early after operations for congenital heart malformations of mode rate to severe complexity. The second aim was to correlate complement and c ytokine activation during the same period with clinical variables reflectin g the postoperative course. Methods-Prospective descriptive clinical study that involved 22 consecutive children (1-28 months). Five children had Down's syndrome. Concentrations of C3a, C5b-9 and IL-6 were measured. Results-C3a, C5b-9 and IL-6 increased significantly during the study period (ANOVA: C3a, p = 0.001; C5b-9, p = 0; IL-6, p = 0). C3a correlated with pr eoperative haemoglobin (r = 0.71, p = 0.0002) and CPB time (r = 0.72, p = 0 .0005). C5b-9 correlated with CPB time (r = 0.58, p = 0.004). IL-6 related to presence of Down's syndrome (p = 0.0001) and correlated with preoperativ e haemoglobin (r = 0.55, p = 0.02), preoperative weight deviation (r = -0.5 2, p = 0.03) and time in the ventilator (r = 0.68, p = 0.002) Conclusions-Preoperative and perioperative characteristics predict the infl ammatory response during open heart surgery in infants and small children. IL-6 response is related to the postoperative course.