Adrenomedullin alterations related to cardiopulmonary bypass in infants with low cardiac output syndrome

Raul Abella, Angela Satriano, Alessandro Frigiola, Alessandro Varrica, Antonio D. W. Gavilanes, Luc J. Zimmermann, Hans J. S. Vles, Pasquale Florio, Maria Grazia Calevo, Diego Gazzolo*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background: Low cardiac output syndrome (LCOS) remains a major perioperative complications in infants subjected to open-heart surgery with cardiopulmonary bypass (CPB). The present study investigated whether perioperative blood assessment of a potent vasoactive peptide namely adrenomedullin (AM) can predict the risk of LCOS. Methods: We measured AM levels in 48 patients (LCOS: n = 9; controls: n = 39) undergone to open-heart surgery with CPB at five predetermined time points before, during and after the surgery. Clinical, laboratory and perioperative data were analyzed by a multiple logistic regression model. Results: AM significantly decreased (p <0.01) during and after the surgical procedure exhibiting a dip at the end of the CPB. Multivariable analysis demonstrated significant correlations among LCOS, AM measured at the end of CPB (p <0.001), and cooling duration (p <0.05). AM at 27 pg/L cutoff achieved a sensitivity of 100% and a specificity of 64.1%, while cooling at 11-min cutoff combined a sensitivity of 55.6% and a specificity of 92.3% for LCOS prediction. Conclusions: This study suggests that AM can constitute, alone or combined with standard parameters, a promising predictor of LCOS in infants subjected to open-heart surgery with CPB.
Original languageEnglish
Pages (from-to)2756-2761
JournalJournal of Maternal-Fetal & Neonatal Medicine
Issue number12
Publication statusPublished - Dec 2012


  • Adrenomedullin
  • cardiopulmonary bypass
  • newborn

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