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Plasma angiopoietin-2 levels increase in children following cardiopulmonary bypass

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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.

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Acknowledgments

We would like thank Tracey VanVliet and Lois Bogenschutz in the Cardiology research department at Cincinnati Children’s Hospital for their assistance with this project. The study was supported by the National Institutes of Health KO8 GM077432 (DSW).

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Authors and Affiliations

  1. Division of Critical Care Medicine, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229-3039, USA

    John S. Giuliano Jr, Patrick M. Lahni, Michael T. Bigham, Hector R. Wong & Derek S. Wheeler

  2. Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, USA

    John S. Giuliano Jr, Patrick M. Lahni, Michael T. Bigham, Hector R. Wong & Derek S. Wheeler

  3. The Kindervelt Laboratory for Critical Care Medicine Research, Cincinnati Children’s Research Foundation, Cincinnati, USA

    Patrick M. Lahni, Hector R. Wong & Derek S. Wheeler

  4. Division of Cardiothoracic Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, USA

    Peter B. Manning

  5. Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, USA

    Peter B. Manning

  6. Division of Cardiology, Texas Children’s Hospital, Houston, USA

    David P. Nelson

  7. Department of Pediatrics, Baylor College of Medicine, Houston, USA

    David P. Nelson

Authors
  1. John S. Giuliano Jr
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  2. Patrick M. Lahni
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  3. Michael T. Bigham
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  4. Peter B. Manning
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  5. David P. Nelson
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  6. Hector R. Wong
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  7. Derek S. Wheeler
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Corresponding author

Correspondence to Derek S. Wheeler.

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Giuliano, J.S., Lahni, P.M., Bigham, M.T. et al. Plasma angiopoietin-2 levels increase in children following cardiopulmonary bypass. Intensive Care Med 34, 1851–1857 (2008). https://doi.org/10.1007/s00134-008-1174-9

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  • DOI: https://doi.org/10.1007/s00134-008-1174-9

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