Original

Intensive Care Medicine

, Volume 34, Issue 10, pp 1851-1857

Plasma angiopoietin-2 levels increase in children following cardiopulmonary bypass

  • John S. GiulianoJrAffiliated withDivision of Critical Care Medicine, Cincinnati Children’s Hospital Medical CenterDepartment of Pediatrics, University of Cincinnati College of Medicine
  • , Patrick M. LahniAffiliated withDivision of Critical Care Medicine, Cincinnati Children’s Hospital Medical CenterDepartment of Pediatrics, University of Cincinnati College of MedicineThe Kindervelt Laboratory for Critical Care Medicine Research, Cincinnati Children’s Research Foundation
  • , Michael T. BighamAffiliated withDivision of Critical Care Medicine, Cincinnati Children’s Hospital Medical CenterDepartment of Pediatrics, University of Cincinnati College of Medicine
  • , Peter B. ManningAffiliated withDivision of Cardiothoracic Surgery, Cincinnati Children’s Hospital Medical CenterDepartment of Surgery, University of Cincinnati College of Medicine
  • , David P. NelsonAffiliated withDivision of Cardiology, Texas Children’s HospitalDepartment of Pediatrics, Baylor College of Medicine
  • , Hector R. WongAffiliated withDivision of Critical Care Medicine, Cincinnati Children’s Hospital Medical CenterDepartment of Pediatrics, University of Cincinnati College of MedicineThe Kindervelt Laboratory for Critical Care Medicine Research, Cincinnati Children’s Research Foundation
  • , Derek S. WheelerAffiliated withDivision of Critical Care Medicine, Cincinnati Children’s Hospital Medical CenterDepartment of Pediatrics, University of Cincinnati College of MedicineThe Kindervelt Laboratory for Critical Care Medicine Research, Cincinnati Children’s Research Foundation Email author 

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Abstract

Objective

The aim was to investigate the effects of cardiopulmonary bypass (CPB) on plasma levels of the vascular growth factors, angiopoietin (angpt)-1, angpt-2, and vascular endothelial growth factor (VEGF).

Design

The design was a prospective, clinical investigation.

Setting

The setting was a 12-bed pediatric cardiac intensive care unit of a tertiary children’s medical center.

Patients

The patients were 48 children (median age, 5 months) undergoing surgical correction or palliation of congenital heart disease who were prospectively enrolled following informed consent.

Interventions

There were no interventions in this study.

Measurements and results

Plasma samples were obtained at baseline and at 0, 6, and 24 h following CPB. Angpt-1, angpt-2, and VEGF levels were measured via commercial ELISA. Angpt-2 levels increased by 6 h (0.95, IQR 0.43–2.08 ng mL−1 vs. 4.62, IQR 1.16–6.93 ng mL−1, P < 0.05) and remained significantly elevated at 24 h after CPB (1.85, IQR 0.70–2.76 ng mL−1; P < 0.05). Angpt-1 levels remained unchanged immediately after CPB, but were significantly decreased at 24 h after CPB (0.64, IQR 0.40–1.62 ng mL−1 vs. 1.99, IQR 1.23–2.63 ng mL−1, P < 0.05). Angpt-2 levels correlated significantly with cardiac intensive care unit (CICU) length of stay (LOS) and were an independent predictor for CICU LOS on subsequent multivariate analysis.

Conclusions

Angpt-2 appears to be an important biomarker of adverse outcome following CPB in children.

Keywords

Vascular growth factor Cardiopulmonary bypass Inflammation Pediatrics Congenital heart disease Systemic inflammatory response syndrome (SIRS)