TY - JOUR
T1 - Adrenomedullin alterations related to cardiopulmonary bypass in infants with low cardiac output syndrome
AU - Abella, Raul
AU - Satriano, Angela
AU - Frigiola, Alessandro
AU - Varrica, Alessandro
AU - Gavilanes, Antonio D. W.
AU - Zimmermann, Luc J.
AU - Vles, Hans J. S.
AU - Florio, Pasquale
AU - Calevo, Maria Grazia
AU - Gazzolo, Diego
PY - 2012/12
Y1 - 2012/12
N2 - 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.
AB - 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.
KW - Adrenomedullin
KW - cardiopulmonary bypass
KW - newborn
U2 - 10.3109/14767058.2012.718393
DO - 10.3109/14767058.2012.718393
M3 - Article
C2 - 22881718
SN - 1476-7058
VL - 25
SP - 2756
EP - 2761
JO - Journal of Maternal-Fetal & Neonatal Medicine
JF - Journal of Maternal-Fetal & Neonatal Medicine
IS - 12
ER -