Oxidative stress response in children undergoing cardiac surgery: Utility of the clearance of isoprostanes
Cardiac surgery (CS) in pediatric patients induces an overt oxidative stress (OS) response. Children are particularly vulnerable to OS related injury. The immaturity of their organs and antioxidant systems as well as the induction of OS in cardio-pulmonary bypass (CPB) surgery may have an important...
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| description | Cardiac surgery (CS) in pediatric patients induces an overt oxidative stress (OS) response. Children are particularly vulnerable to OS related injury. The immaturity of their organs and antioxidant systems as well as the induction of OS in cardio-pulmonary bypass (CPB) surgery may have an important impact on outcomes. The purpose of this study was to describe the OS response, measured by urinary free 8-iso-PGF2α, in infants undergoing CS and to evaluate the relationship between OS response and post-operative clinical outcomes.
Infants with congenital heart disease undergoing CS with or without CPB were eligible for enrollment. Children were classified as neonates ( |
| doi_str_mv | 10.1371/journal.pone.0250124 |
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Infants with congenital heart disease undergoing CS with or without CPB were eligible for enrollment. Children were classified as neonates (<30 days) or infants (30 days-6 months) based on the age at surgery. Perioperative continuous non-invasive neuromonitoring included amplitude-integrated electroencephalogram and cerebral regional oxygen saturation measured with near-infrared spectroscopy. Urine 8-iso-PGF2α levels were measured before, immediately post-, and 24-hours post-surgery, and the 8-iso-PGF2 clearance was calculated.
Sixty-two patients (60% neonates) were included. Urine 8-iso-PGF2α levels 24 hours after surgery (8.04 [6.4-10.3] ng/mg Cr) were higher than pre-operative levels (5.7 [4.65-7.58] ng/mg Cr) (p<0.001). Those patients with a severe degree of cyanosis caused by Transposition of the Great Arteries (TGA) had the highest post-operative 8-iso-PGF2α levels. Patients with intra-operative seizures had higher post-operative 8-iso-PGF2α levels. 8-iso-PGF2α clearance at 24 hours post-surgery was different between newborns and infant patients, and it was inversely correlated with days of mechanical ventilation (p = 0.05), ICU LOS (p = 0.05) and VIS score at 24 hours (p = 0.036).
Children undergoing CS, particularly neonatal patients, experience a significant post-operative OS response that might play an important role in postoperative morbidity. TGA patients undergoing arterial switch operations demonstrate the highest post-operative OS response. Rapid clearance of isoprostanes, which occurs more frequently in older patients with more mature antioxidant systems, might be associated with better clinical outcomes.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0250124</identifier><identifier>PMID: 34228731</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Anesthesia ; Antioxidants ; Arteries ; Biology and Life Sciences ; Biomarkers ; Blood ; Cardiac Surgical Procedures - adverse effects ; Cardiopulmonary Bypass - adverse effects ; Cardiovascular diseases ; Chemical compounds ; Children ; Clinical outcomes ; Coronary artery disease ; Creatinine ; Cyanosis ; Diagnosis ; Dinoprost - analogs & derivatives ; Dinoprost - urine ; EEG ; Female ; Free radicals ; Heart ; Heart Defects, Congenital - metabolism ; Heart Defects, Congenital - surgery ; Heart diseases ; Heart surgery ; Hemoglobin ; Hospitals ; Humans ; Independent sample ; Infant ; Infant, Newborn ; Infants ; Infrared spectra ; Infrared spectroscopy ; Isoprostanes ; Isoprostanes - urine ; Male ; Mechanical ventilation ; Medicine and Health Sciences ; Morbidity ; Near infrared radiation ; Near infrared spectroscopy ; Neonates ; Newborn babies ; Organs ; Oxidative Stress ; Oxygen ; Oxygen content ; Patients ; Pediatrics ; People and Places ; Physiology ; Seizures ; Surgery ; Transposition ; Urine ; Ventilation</subject><ispartof>PloS one, 2021-07, Vol.16 (7), p.e0250124</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Hadley et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 Hadley et al 2021 Hadley et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-d0ccbfeee30024b48d006f83a6dfef28133248837c49ddc8af87d7de6ee3fe853</citedby><cites>FETCH-LOGICAL-c692t-d0ccbfeee30024b48d006f83a6dfef28133248837c49ddc8af87d7de6ee3fe853</cites><orcidid>0000-0002-9108-4750 ; 0000-0001-9202-4664</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8259993/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8259993/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2100,2926,23865,27923,27924,53790,53792,79371,79372</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34228731$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Lopez-Delgado, Juan Carlos</contributor><creatorcontrib>Hadley, Stephanie</creatorcontrib><creatorcontrib>Cañizo Vazquez, Debora</creatorcontrib><creatorcontrib>Lopez Abad, Miriam</creatorcontrib><creatorcontrib>Congiu, Stefano</creatorcontrib><creatorcontrib>Lushchencov, Dmytro</creatorcontrib><creatorcontrib>Camprubí Camprubí, Marta</creatorcontrib><creatorcontrib>Sanchez-de-Toledo, Joan</creatorcontrib><title>Oxidative stress response in children undergoing cardiac surgery: Utility of the clearance of isoprostanes</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Cardiac surgery (CS) in pediatric patients induces an overt oxidative stress (OS) response. Children are particularly vulnerable to OS related injury. The immaturity of their organs and antioxidant systems as well as the induction of OS in cardio-pulmonary bypass (CPB) surgery may have an important impact on outcomes. The purpose of this study was to describe the OS response, measured by urinary free 8-iso-PGF2α, in infants undergoing CS and to evaluate the relationship between OS response and post-operative clinical outcomes.
Infants with congenital heart disease undergoing CS with or without CPB were eligible for enrollment. Children were classified as neonates (<30 days) or infants (30 days-6 months) based on the age at surgery. Perioperative continuous non-invasive neuromonitoring included amplitude-integrated electroencephalogram and cerebral regional oxygen saturation measured with near-infrared spectroscopy. Urine 8-iso-PGF2α levels were measured before, immediately post-, and 24-hours post-surgery, and the 8-iso-PGF2 clearance was calculated.
Sixty-two patients (60% neonates) were included. Urine 8-iso-PGF2α levels 24 hours after surgery (8.04 [6.4-10.3] ng/mg Cr) were higher than pre-operative levels (5.7 [4.65-7.58] ng/mg Cr) (p<0.001). Those patients with a severe degree of cyanosis caused by Transposition of the Great Arteries (TGA) had the highest post-operative 8-iso-PGF2α levels. Patients with intra-operative seizures had higher post-operative 8-iso-PGF2α levels. 8-iso-PGF2α clearance at 24 hours post-surgery was different between newborns and infant patients, and it was inversely correlated with days of mechanical ventilation (p = 0.05), ICU LOS (p = 0.05) and VIS score at 24 hours (p = 0.036).
Children undergoing CS, particularly neonatal patients, experience a significant post-operative OS response that might play an important role in postoperative morbidity. TGA patients undergoing arterial switch operations demonstrate the highest post-operative OS response. Rapid clearance of isoprostanes, which occurs more frequently in older patients with more mature antioxidant systems, might be associated with better clinical outcomes.</description><subject>Anesthesia</subject><subject>Antioxidants</subject><subject>Arteries</subject><subject>Biology and Life Sciences</subject><subject>Biomarkers</subject><subject>Blood</subject><subject>Cardiac Surgical Procedures - adverse effects</subject><subject>Cardiopulmonary Bypass - adverse effects</subject><subject>Cardiovascular diseases</subject><subject>Chemical compounds</subject><subject>Children</subject><subject>Clinical outcomes</subject><subject>Coronary artery disease</subject><subject>Creatinine</subject><subject>Cyanosis</subject><subject>Diagnosis</subject><subject>Dinoprost - analogs & derivatives</subject><subject>Dinoprost - urine</subject><subject>EEG</subject><subject>Female</subject><subject>Free radicals</subject><subject>Heart</subject><subject>Heart Defects, Congenital - metabolism</subject><subject>Heart Defects, Congenital - surgery</subject><subject>Heart diseases</subject><subject>Heart surgery</subject><subject>Hemoglobin</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Independent sample</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Infants</subject><subject>Infrared spectra</subject><subject>Infrared spectroscopy</subject><subject>Isoprostanes</subject><subject>Isoprostanes - urine</subject><subject>Male</subject><subject>Mechanical ventilation</subject><subject>Medicine and Health Sciences</subject><subject>Morbidity</subject><subject>Near infrared radiation</subject><subject>Near infrared spectroscopy</subject><subject>Neonates</subject><subject>Newborn babies</subject><subject>Organs</subject><subject>Oxidative Stress</subject><subject>Oxygen</subject><subject>Oxygen content</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>People and Places</subject><subject>Physiology</subject><subject>Seizures</subject><subject>Surgery</subject><subject>Transposition</subject><subject>Urine</subject><subject>Ventilation</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk11r2zAUhs3YWLtu_2BshsHYLpLpw5blXQxK2UegENjW3QpZOnIUHCuV5NL8-ymNW-LRi2GwxdFzXvm8OifLXmM0x7TCn9Zu8L3s5lvXwxyREmFSPMlOcU3JjBFEnx6tT7IXIawRKiln7Hl2QgtCeEXxabZe3loto72BPEQPIeTplSQD5LbP1cp22kOfD70G3zrbt7mSXlup8jD4Fvzuc34VbWfjLncmjyvIVQfSy17BPmCD23oXouwhvMyeGdkFeDV-z7Krb19_X_yYXS6_Ly7OL2eK1STONFKqMQBAESJFU3CNEDOcSqYNGMIxpaTgnFaqqLVWXBpe6UoDSxkGeEnPsrcH3W3nghhtCoKUBa85YhgnYnEgtJNrsfV2I_1OOGnFXcD5VkgfbapENEWpqgqDkQYXCrMaNU1ZUmpkJTnnMml9GU8bmg1oBX30spuITnd6uxKtuxGclHVd0yTwYRTw7nqAEMXGBgVdlzxzw91_1wRhWqCEvvsHfby6kWplKsD2xqVz1V5UnDNWMUSSr4maP0KlR8PGqtRTxqb4JOHjJCExEW5jK4cQxOLXz_9nl3-m7PsjdgWyi6vguiHa1IVTsDiAKnVU8GAeTMZI7Efi3g2xHwkxjkRKe3N8QQ9J9zNA_wKl7AiD</recordid><startdate>20210706</startdate><enddate>20210706</enddate><creator>Hadley, 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stress response in children undergoing cardiac surgery: Utility of the clearance of isoprostanes</title><author>Hadley, Stephanie ; Cañizo Vazquez, Debora ; Lopez Abad, Miriam ; Congiu, Stefano ; Lushchencov, Dmytro ; Camprubí Camprubí, Marta ; Sanchez-de-Toledo, Joan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-d0ccbfeee30024b48d006f83a6dfef28133248837c49ddc8af87d7de6ee3fe853</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Anesthesia</topic><topic>Antioxidants</topic><topic>Arteries</topic><topic>Biology and Life Sciences</topic><topic>Biomarkers</topic><topic>Blood</topic><topic>Cardiac Surgical Procedures - adverse effects</topic><topic>Cardiopulmonary Bypass - adverse effects</topic><topic>Cardiovascular diseases</topic><topic>Chemical compounds</topic><topic>Children</topic><topic>Clinical outcomes</topic><topic>Coronary artery 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children undergoing cardiac surgery: Utility of the clearance of isoprostanes</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2021-07-06</date><risdate>2021</risdate><volume>16</volume><issue>7</issue><spage>e0250124</spage><pages>e0250124-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Cardiac surgery (CS) in pediatric patients induces an overt oxidative stress (OS) response. Children are particularly vulnerable to OS related injury. The immaturity of their organs and antioxidant systems as well as the induction of OS in cardio-pulmonary bypass (CPB) surgery may have an important impact on outcomes. The purpose of this study was to describe the OS response, measured by urinary free 8-iso-PGF2α, in infants undergoing CS and to evaluate the relationship between OS response and post-operative clinical outcomes.
Infants with congenital heart disease undergoing CS with or without CPB were eligible for enrollment. Children were classified as neonates (<30 days) or infants (30 days-6 months) based on the age at surgery. Perioperative continuous non-invasive neuromonitoring included amplitude-integrated electroencephalogram and cerebral regional oxygen saturation measured with near-infrared spectroscopy. Urine 8-iso-PGF2α levels were measured before, immediately post-, and 24-hours post-surgery, and the 8-iso-PGF2 clearance was calculated.
Sixty-two patients (60% neonates) were included. Urine 8-iso-PGF2α levels 24 hours after surgery (8.04 [6.4-10.3] ng/mg Cr) were higher than pre-operative levels (5.7 [4.65-7.58] ng/mg Cr) (p<0.001). Those patients with a severe degree of cyanosis caused by Transposition of the Great Arteries (TGA) had the highest post-operative 8-iso-PGF2α levels. Patients with intra-operative seizures had higher post-operative 8-iso-PGF2α levels. 8-iso-PGF2α clearance at 24 hours post-surgery was different between newborns and infant patients, and it was inversely correlated with days of mechanical ventilation (p = 0.05), ICU LOS (p = 0.05) and VIS score at 24 hours (p = 0.036).
Children undergoing CS, particularly neonatal patients, experience a significant post-operative OS response that might play an important role in postoperative morbidity. TGA patients undergoing arterial switch operations demonstrate the highest post-operative OS response. Rapid clearance of isoprostanes, which occurs more frequently in older patients with more mature antioxidant systems, might be associated with better clinical outcomes.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>34228731</pmid><doi>10.1371/journal.pone.0250124</doi><tpages>e0250124</tpages><orcidid>https://orcid.org/0000-0002-9108-4750</orcidid><orcidid>https://orcid.org/0000-0001-9202-4664</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2021-07, Vol.16 (7), p.e0250124 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2548980611 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS); PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Anesthesia Antioxidants Arteries Biology and Life Sciences Biomarkers Blood Cardiac Surgical Procedures - adverse effects Cardiopulmonary Bypass - adverse effects Cardiovascular diseases Chemical compounds Children Clinical outcomes Coronary artery disease Creatinine Cyanosis Diagnosis Dinoprost - analogs & derivatives Dinoprost - urine EEG Female Free radicals Heart Heart Defects, Congenital - metabolism Heart Defects, Congenital - surgery Heart diseases Heart surgery Hemoglobin Hospitals Humans Independent sample Infant Infant, Newborn Infants Infrared spectra Infrared spectroscopy Isoprostanes Isoprostanes - urine Male Mechanical ventilation Medicine and Health Sciences Morbidity Near infrared radiation Near infrared spectroscopy Neonates Newborn babies Organs Oxidative Stress Oxygen Oxygen content Patients Pediatrics People and Places Physiology Seizures Surgery Transposition Urine Ventilation |
| title | Oxidative stress response in children undergoing cardiac surgery: Utility of the clearance of isoprostanes |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-12T15%3A51%3A27IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Oxidative%20stress%20response%20in%20children%20undergoing%20cardiac%20surgery:%20Utility%20of%20the%20clearance%20of%20isoprostanes&rft.jtitle=PloS%20one&rft.au=Hadley,%20Stephanie&rft.date=2021-07-06&rft.volume=16&rft.issue=7&rft.spage=e0250124&rft.pages=e0250124-&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0250124&rft_dat=%3Cgale_plos_%3EA667602024%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2548980611&rft_id=info:pmid/34228731&rft_galeid=A667602024&rft_doaj_id=oai_doaj_org_article_b45c771efaf14c1690bb5533fa7a888a&rfr_iscdi=true |