Premium
A polipoprotein E Levels in Pediatric Patients Undergoing Cardiopulmonary Bypass
Author(s) -
Aĝirbaşli Mehmet,
Song Jianxun,
Lei Fengyang,
Wang Shigang,
Kunselman Allen R.,
Clark Joseph B.,
Myers John L.,
Ündar Akif
Publication year - 2015
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/aor.12444
Subject(s) - cardiopulmonary bypass , medicine , pulsatile flow , apolipoprotein e , heart disease , apolipoprotein b , anesthesia , cardiology , disease , cholesterol
Abstract Apolipoprotein E ( apoE ) may play a critical role in modulating the response to neurological injury after cardiopulmonary bypass ( CPB ) in children. Plasma samples were collected from 38 pediatric patients. Half of the patients received nonpulsatile flow and the other half underwent pulsatile flow during CPB . Plasma samples were collected at three time points: at baseline prior to incision ( T 1), 1 h after CPB ( T 2), and 24 h after CPB ( T 3). The study included 38 pediatric patients undergoing heart surgery (mean age 2.5 ± 2.1 years). Baseline apoE levels were low (<30 μg/mL) in 21 patients (55%). Apo E levels were significantly decreased at 1 h after CPB compared with baseline (22 ± 14 vs. 34 ± 18 μg/mL, P = 0.001). At 24 h after CPB , apoE levels were significantly increased compared with baseline (47 ± 25 vs. 34 ± 18 μg/mL, P = 0.002). Pulsatile mode was associated with lower apo E levels at 24 h after CPB compared with nonpulsatile mode (38 ± 14 vs. 57 ± 29 μg/mL, P = 0.018). Apo E levels correlated negatively with pump time ( r = −0.525, P = 0.021) and cross‐clamp time ( r = −0.464, P = 0.045) at 24 h following CPB for the nonpulsatile group but not for the pulsatile group. In this cohort of young children with congenital heart disease, baseline apoE levels were low in the majority of patients prior to surgery. Apo E levels decreased further at 1 h after CPB , and then significantly increased by 24 h. The mode of perfusion and the duration of pump time and clamp time influence the apo E levels after CPB . An improved understanding of these mechanisms may translate into the development of new techniques to improve the clinical outcomes after pediatric CPB .