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| Title |
IL-6 AS A MARKER OF POSTOPERATIVE OUTCOME IN
NEONATES WITH TRANSPOSITION OF GREAT ARTERIES |
| Author |
E Appachi MD, E Mossad M Kapural MD, J
Drummond-Webb MD P Bokesch MD, RBB Mee MB Bch |
| Affiliation |
Department of Pediatric Critical Care and
Cardiothoracic Anesthesia, The Cleveland Clinic Foundation, Cleveland, Ohio |
| Introduction |
The surgical repair of transposition of great
arteries (TGA) requires cardiopulmonary bypass (CPB). The CPB induces a systemic
inflammatory response and it is maintained by several factors including cytokines
production and results in capillary leak, organ damage and postoperative morbidity. Serum
interleukin concentrations (IL-6) have been used as indicators of activation of the
inflammatory cascade by the cardiopulmonary bypass. The purpose of this study is to
evaluate the correlation of serum IL-6 concentrations and clinical outcome in neonates
with TGA. |
| Method |
With institutional approval and informed
parental consent, we studied 12 neonates with TGA scheduled for arterial switch operation
under cardiopulmonary bypass. The infants were anesthetized with fentanyl, midozolam and
isoflurane. The arterial switch operation was done in the usual manner. Blood samples for
IL-6 analysis were obtained pre-incision, on CPB, and 1,3,6, and 24 hours postoperatively
and analyzed using ELISA. Using Spearman=s correlation, the relation of IL-6 concentration
to age at operation and immediate postoperative clinical outcome were studied. |
| Result |
Preoperative IL-6 concentration was 12.4+/- 13.2
pg/ml and inversely correlated with age at operation (r-0.92, p=0.01). IL-6 concentration
peaked at 6 hours postoperatively (87.8+/-70.6 pg/ml) and correlated significantly with
time to extubation (r-0.67, p=0.05) and peritoneal fluid drainage volume (r-0.75, p=0.02).
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| Conclusion |
Serum IL-6 concentration can be used as a marker
for timing of surgery in neonates with TGA presenting for surgical correction and to
predict postoperative morbidity secondary to activation of the inflammatory cascade. |
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