Abstract
Background
In children with congenital heart disease (CHD), altered pulmonary circulation compromises gas exchange. Moreover, pulmonary dysfunction is a complication of cardiac surgery with cardiopulmonary bypass (CPB). No data are available on the effect of different CHDs on lung injury. The aim of this study was to analyze epithelial lining fluid (ELF) surfactant composition in children with CHD.
Methods
Tracheal aspirates (TAs) from 72 CHD children (age 2.9 (0.4–5.7) months) were obtained before and after CPB. We measured ELF phospholipids, surfactant proteins A and B (SP-A, SP-B), albumin, and myeloperoxidase activity. TAs from 12 infants (age 1.0 (0.9–2.9) months) with normal heart/lung served as controls.
Results
Heart defects were transposition of great arteries (19), tetralogy of Fallot (TOF, 20), atrial/ventricular septal defect (ASD/VSD, 22), and hypoplastic left heart syndrome (11). Increased levels of ELF SP-B were found in all defects, increased myeloperoxidase activity in all except the TOF, and increased levels of ELF albumin and SP-A only in ASD/VSD patients. Postoperatively, ELF findings remained unchanged except for a further increase in myeloperoxidase activity.
Conclusion
ELF composition has distinctive patterns in different CHD. We speculate that a better knowledge of the ELF biochemical changes may help to prevent respiratory complications.
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Acknowledgements
This study was supported by Fondazione Just Italia “Bando Nazionale 2016” and by Cariparo Young Investigator on Pediatric Research 2013.
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Simonato, M., Baritussio, A., Carnielli, V. et al. Influence of the type of congenital heart defects on epithelial lining fluid composition in infants undergoing cardiac surgery with cardiopulmonary bypass. Pediatr Res 83, 791–797 (2018). https://doi.org/10.1038/pr.2017.326
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DOI: https://doi.org/10.1038/pr.2017.326
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