The Effect of Methylprednisolone on Plasma Concentrations of Neutrophil Gelatinase-Associated Lipocalin in Pediatric Heart Surgery
Plasma neutrophil gelatinase-associated lipocalin is a kidney injury marker used in pediatric heart surgery. Neutrophil gelatinase-associated lipocalin is also a constituent of specific granules of neutrophils. Corticosteroids are widely used in pediatric heart surgery. Methylprednisolone inhibits d...
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| Veröffentlicht in: | Pediatric critical care medicine 2016-02, Vol.17 (2), p.121-127 |
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| creator | Pesonen, Eero J Suominen, Pertti K Keski-Nisula, Juho Mattila, Ilkka P Rautiainen, Paula Jahnukainen, Timo |
| description | Plasma neutrophil gelatinase-associated lipocalin is a kidney injury marker used in pediatric heart surgery. Neutrophil gelatinase-associated lipocalin is also a constituent of specific granules of neutrophils. Corticosteroids are widely used in pediatric heart surgery. Methylprednisolone inhibits degranulation of neutrophil-specific granules. Use of corticosteroids has not been taken into account in studies of neutrophil gelatinase-associated lipocalin in pediatric heart surgery. We studied the influence of systemically administered methylprednisolone on plasma neutrophil gelatinase-associated lipocalin concentrations in pediatric heart surgery.
Two separate double-blinded randomized trials.
PICU at a university-affiliated hospital.
Forty neonates undergoing open-heart surgery and 45 children undergoing ventricular and atrioventricular septal defect correction.
First trial (neonate trial), 40 neonates undergoing open-heart surgery received either 30 mg/kg IV methylprednisolone (n = 20) or placebo (n = 20). Second trial (ventricular septal defect trial), 45 children undergoing ventricular or atrioventricular septal defect correction received one of the following: 30 mg/kg of methylprednisolone IV after anesthesia induction (n = 15), 30 mg/kg methylprednisolone in the cardiopulmonary bypass prime solution (n = 15), or placebo (n = 15).
Plasma neutrophil gelatinase-associated lipocalin and creatinine were measured in both series. Lactoferrin levels were measured as a marker of neutrophil-specific granules in the ventricular septal defect trial only. No differences in creatinine levels occurred between the groups of either trial. Preoperative, neutrophil gelatinase-associated lipocalin did not differ between the study groups of either trial. Preoperatively administered methylprednisolone in the neonate trial reduced neutrophil gelatinase-associated lipocalin by 41% at 6 hours postoperatively (p = 0.002). Preoperatively administered methylprednisolone in the ventricular septal defect trial reduced neutrophil gelatinase-associated lipocalin by 47% (p = 0.010) and lactoferrin by 52% (p = 0.013) 6 hours postoperatively. Lactoferrin levels in the ventricular septal defect trial correlated with neutrophil gelatinase-associated lipocalin (R = 0.492; p = 0.001) preoperatively and after weaning from cardiopulmonary bypass (R = 0.471; p = 0.001).
Preoperatively administered methylprednisolone profoundly decreases plasma neutrophil gelatinase-associated lipocalin levels |
| doi_str_mv | 10.1097/PCC.0000000000000573 |
| format | Article |
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Two separate double-blinded randomized trials.
PICU at a university-affiliated hospital.
Forty neonates undergoing open-heart surgery and 45 children undergoing ventricular and atrioventricular septal defect correction.
First trial (neonate trial), 40 neonates undergoing open-heart surgery received either 30 mg/kg IV methylprednisolone (n = 20) or placebo (n = 20). Second trial (ventricular septal defect trial), 45 children undergoing ventricular or atrioventricular septal defect correction received one of the following: 30 mg/kg of methylprednisolone IV after anesthesia induction (n = 15), 30 mg/kg methylprednisolone in the cardiopulmonary bypass prime solution (n = 15), or placebo (n = 15).
Plasma neutrophil gelatinase-associated lipocalin and creatinine were measured in both series. Lactoferrin levels were measured as a marker of neutrophil-specific granules in the ventricular septal defect trial only. No differences in creatinine levels occurred between the groups of either trial. Preoperative, neutrophil gelatinase-associated lipocalin did not differ between the study groups of either trial. Preoperatively administered methylprednisolone in the neonate trial reduced neutrophil gelatinase-associated lipocalin by 41% at 6 hours postoperatively (p = 0.002). Preoperatively administered methylprednisolone in the ventricular septal defect trial reduced neutrophil gelatinase-associated lipocalin by 47% (p = 0.010) and lactoferrin by 52% (p = 0.013) 6 hours postoperatively. Lactoferrin levels in the ventricular septal defect trial correlated with neutrophil gelatinase-associated lipocalin (R = 0.492; p = 0.001) preoperatively and after weaning from cardiopulmonary bypass (R = 0.471; p = 0.001).
Preoperatively administered methylprednisolone profoundly decreases plasma neutrophil gelatinase-associated lipocalin levels. Neutrophil gelatinase-associated lipocalin seems to originate to a significant extent from activated neutrophils. Preoperative methylprednisolone is a confounding factor when interpreting plasma neutrophil gelatinase-associated lipocalin levels as a kidney injury marker in pediatric heart surgery.</description><identifier>ISSN: 1529-7535</identifier><identifier>DOI: 10.1097/PCC.0000000000000573</identifier><identifier>PMID: 26509817</identifier><language>eng</language><publisher>United States</publisher><subject>Acute Kidney Injury - blood ; Acute Kidney Injury - etiology ; Acute-Phase Proteins - drug effects ; Biomarkers - blood ; Cardiac Surgical Procedures ; Double-Blind Method ; Female ; Glucocorticoids - administration & dosage ; Hospitals, University ; Humans ; Infant ; Infant, Newborn ; Intensive Care Units, Pediatric ; Lipocalin-2 ; Lipocalins - blood ; Lipocalins - drug effects ; Male ; Methylprednisolone - administration & dosage ; Proto-Oncogene Proteins - blood ; Proto-Oncogene Proteins - drug effects</subject><ispartof>Pediatric critical care medicine, 2016-02, Vol.17 (2), p.121-127</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c377t-5133efa46454d00cc69805fbcf2c4bcabe00076341afd804386fb68604522ab13</citedby><cites>FETCH-LOGICAL-c377t-5133efa46454d00cc69805fbcf2c4bcabe00076341afd804386fb68604522ab13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26509817$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pesonen, Eero J</creatorcontrib><creatorcontrib>Suominen, Pertti K</creatorcontrib><creatorcontrib>Keski-Nisula, Juho</creatorcontrib><creatorcontrib>Mattila, Ilkka P</creatorcontrib><creatorcontrib>Rautiainen, Paula</creatorcontrib><creatorcontrib>Jahnukainen, Timo</creatorcontrib><title>The Effect of Methylprednisolone on Plasma Concentrations of Neutrophil Gelatinase-Associated Lipocalin in Pediatric Heart Surgery</title><title>Pediatric critical care medicine</title><addtitle>Pediatr Crit Care Med</addtitle><description>Plasma neutrophil gelatinase-associated lipocalin is a kidney injury marker used in pediatric heart surgery. Neutrophil gelatinase-associated lipocalin is also a constituent of specific granules of neutrophils. Corticosteroids are widely used in pediatric heart surgery. Methylprednisolone inhibits degranulation of neutrophil-specific granules. Use of corticosteroids has not been taken into account in studies of neutrophil gelatinase-associated lipocalin in pediatric heart surgery. We studied the influence of systemically administered methylprednisolone on plasma neutrophil gelatinase-associated lipocalin concentrations in pediatric heart surgery.
Two separate double-blinded randomized trials.
PICU at a university-affiliated hospital.
Forty neonates undergoing open-heart surgery and 45 children undergoing ventricular and atrioventricular septal defect correction.
First trial (neonate trial), 40 neonates undergoing open-heart surgery received either 30 mg/kg IV methylprednisolone (n = 20) or placebo (n = 20). Second trial (ventricular septal defect trial), 45 children undergoing ventricular or atrioventricular septal defect correction received one of the following: 30 mg/kg of methylprednisolone IV after anesthesia induction (n = 15), 30 mg/kg methylprednisolone in the cardiopulmonary bypass prime solution (n = 15), or placebo (n = 15).
Plasma neutrophil gelatinase-associated lipocalin and creatinine were measured in both series. Lactoferrin levels were measured as a marker of neutrophil-specific granules in the ventricular septal defect trial only. No differences in creatinine levels occurred between the groups of either trial. Preoperative, neutrophil gelatinase-associated lipocalin did not differ between the study groups of either trial. Preoperatively administered methylprednisolone in the neonate trial reduced neutrophil gelatinase-associated lipocalin by 41% at 6 hours postoperatively (p = 0.002). Preoperatively administered methylprednisolone in the ventricular septal defect trial reduced neutrophil gelatinase-associated lipocalin by 47% (p = 0.010) and lactoferrin by 52% (p = 0.013) 6 hours postoperatively. Lactoferrin levels in the ventricular septal defect trial correlated with neutrophil gelatinase-associated lipocalin (R = 0.492; p = 0.001) preoperatively and after weaning from cardiopulmonary bypass (R = 0.471; p = 0.001).
Preoperatively administered methylprednisolone profoundly decreases plasma neutrophil gelatinase-associated lipocalin levels. Neutrophil gelatinase-associated lipocalin seems to originate to a significant extent from activated neutrophils. Preoperative methylprednisolone is a confounding factor when interpreting plasma neutrophil gelatinase-associated lipocalin levels as a kidney injury marker in pediatric heart surgery.</description><subject>Acute Kidney Injury - blood</subject><subject>Acute Kidney Injury - etiology</subject><subject>Acute-Phase Proteins - drug effects</subject><subject>Biomarkers - blood</subject><subject>Cardiac Surgical Procedures</subject><subject>Double-Blind Method</subject><subject>Female</subject><subject>Glucocorticoids - administration & dosage</subject><subject>Hospitals, University</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Intensive Care Units, Pediatric</subject><subject>Lipocalin-2</subject><subject>Lipocalins - blood</subject><subject>Lipocalins - drug effects</subject><subject>Male</subject><subject>Methylprednisolone - administration & dosage</subject><subject>Proto-Oncogene Proteins - blood</subject><subject>Proto-Oncogene Proteins - drug effects</subject><issn>1529-7535</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkElr5DAQhXVImCwz_yAEHXNxIlmbfQwmG3RmGiZzNrJcSiuoJUeSD33NL49DFsIUBQWP96qoD6ETSs4padXFuuvOyfcSiu2hQyrqtlKCiQN0lPMTIbSVXP1AB7UUpG2oOkQvDxvAV9aCKThafA9ls_NTgjG4HH0MgGPAa6_zVuMuBgOhJF1cDPnN_hvmkuK0cR7fgF_0oDNUlzlH43SBEa_cFI32LuCl1zAuanIG34JOBf-d0yOk3U-0b7XP8OtjHqN_11cP3W21-nNz112uKsOUKpWgjIHVXHLBR0KMkW1DhB2MrQ0fjB5g-VtJxqm2Y0M4a6QdZCMJF3WtB8qO0dn73inF5xly6bcuG_BeB4hz7qmSdSsFF2Sx8nerSTHnBLafktvqtOsp6d-I9wvx_n_iS-z048I8bGH8Cn3iZq_O0X-w</recordid><startdate>20160201</startdate><enddate>20160201</enddate><creator>Pesonen, Eero J</creator><creator>Suominen, Pertti K</creator><creator>Keski-Nisula, Juho</creator><creator>Mattila, Ilkka P</creator><creator>Rautiainen, Paula</creator><creator>Jahnukainen, Timo</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20160201</creationdate><title>The Effect of Methylprednisolone on Plasma Concentrations of Neutrophil Gelatinase-Associated Lipocalin in Pediatric Heart Surgery</title><author>Pesonen, Eero J ; Suominen, Pertti K ; Keski-Nisula, Juho ; Mattila, Ilkka P ; Rautiainen, Paula ; Jahnukainen, Timo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c377t-5133efa46454d00cc69805fbcf2c4bcabe00076341afd804386fb68604522ab13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Acute Kidney Injury - blood</topic><topic>Acute Kidney Injury - etiology</topic><topic>Acute-Phase Proteins - drug effects</topic><topic>Biomarkers - blood</topic><topic>Cardiac Surgical Procedures</topic><topic>Double-Blind Method</topic><topic>Female</topic><topic>Glucocorticoids - administration & dosage</topic><topic>Hospitals, University</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Intensive Care Units, Pediatric</topic><topic>Lipocalin-2</topic><topic>Lipocalins - blood</topic><topic>Lipocalins - drug effects</topic><topic>Male</topic><topic>Methylprednisolone - administration & dosage</topic><topic>Proto-Oncogene Proteins - blood</topic><topic>Proto-Oncogene Proteins - drug effects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pesonen, Eero J</creatorcontrib><creatorcontrib>Suominen, Pertti K</creatorcontrib><creatorcontrib>Keski-Nisula, Juho</creatorcontrib><creatorcontrib>Mattila, Ilkka P</creatorcontrib><creatorcontrib>Rautiainen, Paula</creatorcontrib><creatorcontrib>Jahnukainen, Timo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric critical care medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pesonen, Eero J</au><au>Suominen, Pertti K</au><au>Keski-Nisula, Juho</au><au>Mattila, Ilkka P</au><au>Rautiainen, Paula</au><au>Jahnukainen, Timo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Effect of Methylprednisolone on Plasma Concentrations of Neutrophil Gelatinase-Associated Lipocalin in Pediatric Heart Surgery</atitle><jtitle>Pediatric critical care medicine</jtitle><addtitle>Pediatr Crit Care Med</addtitle><date>2016-02-01</date><risdate>2016</risdate><volume>17</volume><issue>2</issue><spage>121</spage><epage>127</epage><pages>121-127</pages><issn>1529-7535</issn><abstract>Plasma neutrophil gelatinase-associated lipocalin is a kidney injury marker used in pediatric heart surgery. Neutrophil gelatinase-associated lipocalin is also a constituent of specific granules of neutrophils. Corticosteroids are widely used in pediatric heart surgery. Methylprednisolone inhibits degranulation of neutrophil-specific granules. Use of corticosteroids has not been taken into account in studies of neutrophil gelatinase-associated lipocalin in pediatric heart surgery. We studied the influence of systemically administered methylprednisolone on plasma neutrophil gelatinase-associated lipocalin concentrations in pediatric heart surgery.
Two separate double-blinded randomized trials.
PICU at a university-affiliated hospital.
Forty neonates undergoing open-heart surgery and 45 children undergoing ventricular and atrioventricular septal defect correction.
First trial (neonate trial), 40 neonates undergoing open-heart surgery received either 30 mg/kg IV methylprednisolone (n = 20) or placebo (n = 20). Second trial (ventricular septal defect trial), 45 children undergoing ventricular or atrioventricular septal defect correction received one of the following: 30 mg/kg of methylprednisolone IV after anesthesia induction (n = 15), 30 mg/kg methylprednisolone in the cardiopulmonary bypass prime solution (n = 15), or placebo (n = 15).
Plasma neutrophil gelatinase-associated lipocalin and creatinine were measured in both series. Lactoferrin levels were measured as a marker of neutrophil-specific granules in the ventricular septal defect trial only. No differences in creatinine levels occurred between the groups of either trial. Preoperative, neutrophil gelatinase-associated lipocalin did not differ between the study groups of either trial. Preoperatively administered methylprednisolone in the neonate trial reduced neutrophil gelatinase-associated lipocalin by 41% at 6 hours postoperatively (p = 0.002). Preoperatively administered methylprednisolone in the ventricular septal defect trial reduced neutrophil gelatinase-associated lipocalin by 47% (p = 0.010) and lactoferrin by 52% (p = 0.013) 6 hours postoperatively. Lactoferrin levels in the ventricular septal defect trial correlated with neutrophil gelatinase-associated lipocalin (R = 0.492; p = 0.001) preoperatively and after weaning from cardiopulmonary bypass (R = 0.471; p = 0.001).
Preoperatively administered methylprednisolone profoundly decreases plasma neutrophil gelatinase-associated lipocalin levels. Neutrophil gelatinase-associated lipocalin seems to originate to a significant extent from activated neutrophils. Preoperative methylprednisolone is a confounding factor when interpreting plasma neutrophil gelatinase-associated lipocalin levels as a kidney injury marker in pediatric heart surgery.</abstract><cop>United States</cop><pmid>26509817</pmid><doi>10.1097/PCC.0000000000000573</doi><tpages>7</tpages></addata></record> |
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| subjects | Acute Kidney Injury - blood Acute Kidney Injury - etiology Acute-Phase Proteins - drug effects Biomarkers - blood Cardiac Surgical Procedures Double-Blind Method Female Glucocorticoids - administration & dosage Hospitals, University Humans Infant Infant, Newborn Intensive Care Units, Pediatric Lipocalin-2 Lipocalins - blood Lipocalins - drug effects Male Methylprednisolone - administration & dosage Proto-Oncogene Proteins - blood Proto-Oncogene Proteins - drug effects |
| title | The Effect of Methylprednisolone on Plasma Concentrations of Neutrophil Gelatinase-Associated Lipocalin in Pediatric Heart Surgery |
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