Perioperative levels of total IgE correlate with outcomes of prolonged mechanical ventilation after cardiopulmonary bypass in pediatric patients

Pediatric Research
Youjin LiJinfen Liu

Abstract

Although cardiopulmonary bypass (CPB) has been previously studied as risking infection and inflammatory responses, few studies evaluate the relationship of preoperative high total immunoglobulin E (tIgE) to outcomes in pediatric patients predisposed to atopy undergoing cardiac surgery with CPB. Serum tIgE, tumor necrosis factor-α (TNF-α), interleukin-10 (IL-10), IL-4, interferon-γ (IFN-γ), and T-helper type 1/2 (Th1/Th2) ratio were quantified in 104 pediatric patients who underwent surgical repair with CPB. Blood samples were obtained: before operation (T1), at the beginning (T2), and before the completion of CPB (T3), after protamine administration (T4), 4 h after CPB (T5), and on postoperative days 1 and 2 (T6, T7). Data on clinical outcomes were collected prospectively. Compared to 50 cases with normal tIgE, 54 cases with high tIgE were found to have higher TNF-α, IL-10, and IL-4 affected by CPB on the specific timepoints (pTNF-α <  0.001; pIL-10 = 0.035; pIL-4 = 0.001). TIgE levels shifted transiently towards Th2, which may be caused by high tIgE specific to T4. This resulted in the correlation between prolonged duration of mechanical ventilation (IL-4: r = 0.426, p = 0.015; Th1/Th2: r = -0.272, p = 0.043) in patients with ...Continue Reading

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Methods Mentioned

BETA
flow cytometry
enzyme-linked immunosorbent assay

Software Mentioned

GraphPad Prism
FlowJo
Power
SPSS

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