Plasma angiopoietin-2 levels increase in children following cardiopulmonary bypass

John S. Giuliano, Patrick M. Lahni, Michael T. Bigham, Peter B. Manning, David P. Nelson, Hector R. Wong, Derek S. Wheeler

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31 Scopus citations

Abstract

Objective: The aim was to investigate the effects of cardiopulmonary bypass (CPB) on plasma levels of the vascular growth factors, angiopoietin (angpt)-1, angpt-2, and vascular endothelial growth factor (VEGF). Design: The design was a prospective, clinical investigation. Setting: The setting was a 12-bed pediatric cardiac intensive care unit of a tertiary children's medical center. Patients: The patients were 48 children (median age, 5 months) undergoing surgical correction or palliation of congenital heart disease who were prospectively enrolled following informed consent. Interventions: There were no interventions in this study. Measurements and results: Plasma samples were obtained at baseline and at 0, 6, and 24 h following CPB. Angpt-1, angpt-2, and VEGF levels were measured via commercial ELISA. Angpt-2 levels increased by 6 h (0.95, IQR 0.43-2.08 ng mL-1 vs. 4.62, IQR 1.16-6.93 ng mL -1, P < 0.05) and remained significantly elevated at 24 h after CPB (1.85, IQR 0.70-2.76 ng mL-1; P < 0.05). Angpt-1 levels remained unchanged immediately after CPB, but were significantly decreased at 24 h after CPB (0.64, IQR 0.40-1.62 ng mL-1 vs. 1.99, IQR 1.23-2.63 ng mL-1, P < 0.05). Angpt-2 levels correlated significantly with cardiac intensive care unit (CICU) length of stay (LOS) and were an independent predictor for CICU LOS on subsequent multivariate analysis. Conclusions: Angpt-2 appears to be an important biomarker of adverse outcome following CPB in children.

Original languageEnglish
Pages (from-to)1851-1857
Number of pages7
JournalIntensive care medicine
Volume34
Issue number10
DOIs
StatePublished - Oct 2008

Keywords

  • Cardiopulmonary bypass
  • Congenital heart disease
  • Inflammation
  • Pediatrics
  • Systemic inflammatory response syndrome (SIRS)
  • Vascular growth factor

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