Interleukin-6 and procalcitonin in serum of children undergoing cardiac surgery with cardiopulmonary bypass

Abstract

Objective — The aim of our study was to investigate the systemic inflammatory response in children with congenital heart disease undergoing surgical correction with cardiopulmonary bypass. We wanted to discuss interleukin 6 and procalcitonin as components of the systemic inflammatory response syndrome to cardiopulmonary bypass and evaluate postoperative kinetics of these parameters in case of an uncomplicated course.

Methods — Procalcitonin and interleukin 6 were determined before and after cardiopulmonary bypass surgery in 37 children on the day of surgery, the first and fourth postoperative day. The increased procalcitonin and interleukin 6 levels were evaluated in relationship to intraoperative variables such as duration of aortic cross clamping, incisional trauma and cardiac bypass temperature.

Results — Peak levels of procalcitonin were detected on the first postoperative day, while interleukin 6 reached its highest values on the day of surgery. In contrast to interleukin 6 the median values of procalcitonin differed significantly between short versus long aortic clamping time and atriotomy versus ventriculotomy. Interleukin 6 reached normal levels on the fourth postoperative day, while procalcitonin was still clearly above normal.

Conclusions — Serum concentrations of procalcitonin and interleukin 6 were influenced by systemic inflammatory response syndrome following cardiac surgery with cardiopulmonary bypass. Even in case of an uncomplicated course both parameters were elevated for at least four days.While procalcitonin serum concentrations were dependent on aortic clamping time or incisional trauma, interleukin 6 showed no significant relation with these intraoperative variables.

Key Words:

• procalcitonin
• interleukin 6
• systemic inflammatory response syndrome
• cardiopulmonary bypass
• children