Study On Different Temperature Methods Of CPB In Infants With Congenital Heart Disease

Background and objectiveThe progress of open-heart surgery mainly depends on the new technique of cardiopulmonary bypass (CPB). Many studies have clearly shown that CPB can cause systemic inflammatory response and damage to organ's function under hypothermic cardiopulmonary bypass. The postoperative recovery course may be complicated by organ dysfunction, including respiratory failure, renal dysfunction, bleeding disorders, neurological dysfunction, altered liver function, and ultimately, multiple system organ failure (MSOF).The techniques of usual hypothermic cardiopulmonary bypass, which can reduce the metabolic rate and the oxygen consumption of the tissue and organs, in other way ,may delay the recover time of the body's function due to the lower-efficient of the enzymes. In order to learn the injury mechanism of organ dysfunction post operation by CPB and find the suitable CPB methods to cure the infants with congenital heart disease, we carried out serious experiments to research the different affection on the organs under the different temperature of the CPB. The levels of inflammatory cytokines IL-6, IL-8, TNF-αand thyroid hormone T3, T4, FT3, TSH were detected at and after the process of the normothermic and hypothermic CPB and were analyzed. Material and method1,29 infants with ventricular septal defect ( VSD) have been undergone IL-6, IL-8 and TNF-αtests with radioimmunoassay methods under normothermic andhypothermia CPB and were contrasted each other.2,20 infants with VSD have been undergone thyroid hormone tests with radioimmunoassay methods under normothermic and hypothermia CPB and were contrasted each other.Results1,The results revealed that the levels of inflammatory cytokines IL-6,IL-8 and TNF-a decreased significantly at normothermic than them at hypothermia cardiopulmonary bypass (P<0.001); IL-8 has returned to a normal level at 48 hours after aorta cross-clap-off at normothermic, but it was still higher than it in before operation when at hypothermia cardiopulmonary bypass(P<0.05).2,The time for T3 , FT3 and T4 to return to normal level was shorter at normothermic than at the hypothermia. T3 has returned to a normal level at 72 hours after aorta cross-clap-off at normothermic, but it was still lesser than it in preoperation at hypothermia cardiopulmonary bypass (P<0.05); T4 has returned to a normal level after 6 hours cross-clap-off at normothermic, but it was still lesser than it before operation at hypothermia cardiopulmonary bypass( P<0.05); FT3 has returned to a normal level at end of the operation, but it was lower than it in thepreoperative time at hypothermia( P<0.05).3,The recovery time of organ function was shorter in normothermic than it in the hypothermia CPB after open-heart surgery in infants.Conclusions1,CPB could induce obvious inflammatory responses to tissue and organs of thebody. TNF-α,IL-6,and IL-8 were important inflammatory cytokines.2,The inflammatory responses decreased significantly at normothermic than at thehypothermia cardiopulmonary bypass.3,The recovery time of Thyroid hormone was shorter significantly in normothermic than in hypothermia cardiopulmonary bypass.4,Normothermic CPB is better to protect organ function than hypothermic CPBduring open-heart surgery in infants.