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          Institute: MPI für Biochemie     Collection: Former and Other Members     Display Documents

ID: 30295.0, MPI für Biochemie / Former and Other Members
Preoperative prediction of pediatric patients with effusions and edema following cardiopulmonary bypass surgery by serological and routine laboratory data
Authors:Bocsi, J.; Hambsch, J.; Osmancik, P.; Schneider, P.; Valet, G.; Tarnok, A.
Date of Publication (YYYY-MM-DD):2002-04
Title of Journal:Critical Care
Journal Abbrev.:Crit. Care
Issue / Number:3
Start Page:226
End Page:233
Review Status:Peer-review
Audience:Not Specified
Abstract / Description:Aim: Postoperative effusions and edema and capillary leak syndrome in children after cardiac surgery with cardiopulmonary bypass constitute considerable clinical problems. Overshooting immune response is held to be the cause. In a prospective study we investigated whether preoperative immune status differences exist in patients at risk for postsurgical effusions and edema, and to what extent these differences permit prediction of the postoperative outcome. Methods: One-day preoperative serum levels of immunoglobulins, complement, cytokines and chemokines, soluble adhesion molecules and receptors as well as clinical chemistry parameters such as differential counts, creatinine, blood coagulation status (altogether 56 parameters) were analyzed in peripheral blood samples of 75 children (aged 3-18 years) undergoing cardiopulmonary bypass surgery (29 with postoperative effusions and edema within the first postoperative week). Results: Preoperative elevation of the serum level of C3 and C5 complement components, tumor necrosis factor-alpha, percentage of leukocytes that are neutrophils, body weight and decreased percentage of lymphocytes (all P < 0.03) occurred in children developing postoperative effusions and edema. While single parameters did not predict individual outcome, > 86% of the patients with postoperative effusions and oedema were correctly predicted using two different classification algorithms. Data mining by both methods selected nine partially overlapping parameters. The prediction quality was independent of the congenital heart defect. Conclusion: Indicators of inflammation were selected as risk indicators by explorative data analysis. This suggests that preoperative differences in the immune system and capillary permeability status exist in patients at risk for postoperative effusions. These differences are suitable for preoperative risk assessment and may be used for the benefit of the patient and to improve cost effectiveness.
Free Keywords:complement; discriminant analysis; interleukin; predisposition; selectin
Comment of the Author/Creator:Date: 2002, APR
External Publication Status:published
Document Type:Article
Communicated by:N.N.
Affiliations:MPI für Biochemie/Former and Other Members/Cell Biochemistry (G. Valet)
External Affiliations:Univ Leipzig, Res Facil, Heart Ctr Leipzig GmbH, Leipzig,; Germany; Univ Leipzig, Res Facil, Heart Ctr Leipzig GmbH, Leipzig, Germany; Semmelweis Univ, Cytometry Unit, Dept Pathol 1, Budapest, Hungary; Charles Univ, Hosp Kralovske Vinohrady, Cardiac Ctr, Prague, Czech Republic
Identifiers:ISI:000176273400013 [ID No:1]
ISSN:1466-609X [ID No:2]
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