| BackgroundSystemic inflammatory response syndrome (SIRS) induced by cardio- pulmonary bypass (CPB) is an irritant reaction when the bodies are injured by CPB. The excess inflammatory response will induce tissue injury or organ dysfunctions, even severe complications such as inflammation, sepsis , acute respiratory distress syndrome and multiple organs dysfunction syndrome (MODS) will happen. The majority of the inflammatory after CPB are not induced by infections. The traditional inflammatory signs can't reflect the state sensitively in time. So it is important to find an effective and sensitive monitor sign, by which the types and degrees of inflammation can be distinguished and interfered in time. Can procalcitonin(PCT) be an effective and sensitive monitor sign?ObjectiveIn this project, the serum PCT concentrations were compared in perioperative period of infants and children with or without CPB. The affection of CPB on PCT concentrations was observed, and the affect factors in it was analysed. The 16SrRNA genes PCR amplification and genechip hybridization were applied to affirm the bacteria infection, and the PCT concentrations in them were described. The relativity betweenserum PCT concentrations and bacteria infections , and the diagnosis significance of serum PCT were discussed in postoperative bacteria infections for infants and children went CPB.SubjectsI Cardiopulmonary bypass group (CPB group): Thirty-one infants and children with CHD who were performed elective operation under CPB from February to April 2004 in the department of cardiovascular surgery, children's hospital of ZheJiang University were included in this study.II Non-cardiopulmonary bypass group(Non-CPB group): Thirteen cases who had been performed elective operation without CPB at the same days were taken as controls. Eight patients were male, and five were female. Mean age was 8.85 3.58 ( range 2-32 ) months old, and mean weight was 8.19 3.04 ( range 5-14 ) kg.In the CPB group, 2 bacteria infection cases (clinic symptoms and bacteria PCR evidences were applied) were discussed separately. In addition, another 2 cases with organ dysfunctions were excluded. The left 27 cases were divided into 2 subgroups by the pediatric SIRS levels provided by Hayden in the 2nd World Pediatric ICU Conference :1 Non-SIRS group: Six patients were male, and four were female. Mean age was 10.20 4.61 (range 5-18 ) months old, and mean weight was 8.80 2.54 (range 6-14) kg;2 SIRS group: Ten patients were male, and seven were female. Mean age was 10.91 6.54( range 6-14 ) months old, and mean weight was 8.41 2.19 ( range 6-14 ) kg. None of the patients had clinical evidence of acute infection or underlying immune disease, and none were prescribed drug know to interfere with immune response before operations. There was no statistical difference of sex, weight and age betweenCPB group and Non-CPB group.MethodsThe blood samples were obtained at five various time points (preoperative, at the end of CPB or surgery in CPB and Non-CPB groups respectively, 24, 48 and 72 hours postoperative) in both CPB group and Non-CPB group. The serum PCT concentrations were measured by Immunoluminometric assay(ILMA). In CPB group 1ml blood samples were taken at 24, 48 and 72 hours postoperative for 16SrRNA genes PCR amplification and genechip hybridization. At the five time points, WBC and CRP were measured. All of the PCT, CRP and WBC data were revised by the formula: revise = measure (HCT preoperative/ HCT postoperative), and SPSS for windows software 10.0 was applied in data statistic.Results1. Peak serum PCT concentrations occurred on 24h after operations in all groups. Then the values decreased gradually in the following days. On 72h after operations , the serum PCT concentrations had not returned to the preoperative levels, especially in the CPB group.(1) The difference between three groups of serum PCT concentrations was not significant before operations (P>0.05);(2) The end of operations or CPB, there were no significa...
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