This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Williams, H. J Articles by Finn, A. Search for Related Content PubMed PubMed Citation Articles by Williams, H. J Articles by Finn, A. Social Bookmarking                         What's this?

Changes in leucocyte counts and soluble intercellular adhesion molecule-1 and E-selectin during cardiopulmonary bypass in children

University of Sheffield Medical School, Sheffield

Naomi Rebuck

Department of Child Health, University of Sheffield, Sheffield

Martin J Elliott

Hospital for Sick Children, Great Ormond St, London

Adam Finn

Division of Child Health, University of Sheffield, Sheffield, A.Finn{at}shef.ac.uk

A consequence of cardiopulmonary bypass (CPB) in young children is postoperative capillary leak and associated pulmonary dysfunction. Neutrophils sequester in the lungs and may contribute to functional endothelial damage. The endothelial adhesion molecules, E-selectin and intercellular adhesion molecule-1 (ICAM-1), mediate sequential steps in adhesion by binding to leucocyte ligands. Circulating forms of these proteins have been identified. We studied changes in the plasma concentrations of soluble E-selectin and soluble ICAM-1 using fixed phase immunoassays, and associated leucocyte counts in 10 paediatric patients undergoing CPB. Concentrations of soluble L-selectin and soluble ICAM-1 consistently fell during CPB from preoperative levels of 89 ± 17 ng/ml (mean ± 2SEM) and 218 + 61 ng/ml, respectively, to 39 ± 7 ng/ml and 84 ± 24 ng/ml, respectively at the beginning of maximum hypothermia. The haemodilution that occurred during CPB largely explained this fall, but not the more marked decrease in white cell counts that also occurred over this period (6.7 ± 1.1 to 1.7 ± 0.5 x 10⁹/l) which may reflect increased leucocyte sequestration. By 24 h postoperatively, levels of both soluble adhesion molecules approached preoperative concentrations, as did lymphocyte counts. In marked contrast, neutrophil counts rose appreciably towards the end of CPB, and continued to rise to a maximum of 10.9 ± 3.1 x10⁹/l during the immediate postoperative period and remained at these elevated levels 24 h later. Major consistent changes in circulating leucocyte numbers which occur early in cardiopulmonary bypass may reflect changes in adhesion to the endothelium and consequent sequestration. Alterations in the levels of soluble adhesion proteins may influence these processes.

Perfusion, Vol. 13, No. 5, 322-327 (1998)
DOI: 10.1177/026765919801300507


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				P. Ballabh, J. Kumari, A. N. Krauss, J. J. Shin, A. Jain, P. A. M. Auld, M. L. Lesser, and S. Cunningham-Rundles Soluble E-Selectin, Soluble L-Selectin and Soluble ICAM-1 in Bronchopulmonary Dysplasia, and Changes With Dexamethasone Pediatrics, March 1, 2003; 111(3): 461 - 468. [Abstract] [Full Text] [PDF]

				H. A. Hennein Inflammation After Cardiopulmonary Bypass: Therapy for the Postpump Syndrome Seminars in Cardiothoracic and Vascular Anesthesia, September 1, 2001; 5(3): 236 - 255. [Abstract] [PDF]