Oxidative Stress and Indicators of Brain Damage Following Pediatric Heart Surgery
Débora Cañizo Vázquez,
Stephanie M. Hadley,
Marta Pérez Ordóñez,
Miriam Lopez-Abad,
Anna Valls,
Marta López Viñals,
Bosco A. Moscoso,
Sergio Benito Fernandez,
Marta Camprubí-Camprubí,
Joan Sanchez-de-Toledo
Affiliations
Débora Cañizo Vázquez
BCNatal-Barcelona Center for Maternal Fetal and Neonatal Medicine, Hospital Sant Joan de Déu-Hospital Clinic, University of Barcelona, 08950 Barcelona, Spain
Stephanie M. Hadley
Department of Pediatrics, Boston Children’s Hospital, Boston, MA 02115, USA
Marta Pérez Ordóñez
Pediatric Cardiology Department, Sant Joan de Déu Hospital, Cardiovascular Research Group, Sant Joan de Deu Research Institute, 08950 Barcelona, Spain
Miriam Lopez-Abad
BCNatal-Barcelona Center for Maternal Fetal and Neonatal Medicine, Hospital Sant Joan de Déu-Hospital Clinic, University of Barcelona, 08950 Barcelona, Spain
Anna Valls
Institut de Recerca Pediàtrica, Hospital Sant Joan de Déu, 08950 Barcelona, Spain
Marta López Viñals
Department of Anesthesia, Hospital Sant Joan de Déu, 08950 Barcelona, Spain
Bosco A. Moscoso
Department of Cardiothoracic Surgery, Hospital Sant Joan de Déu, 08950 Barcelona, Spain
Sergio Benito Fernandez
Department of Pediatric Critical Care, Hospital Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, 08950 Barcelona, Spain
Marta Camprubí-Camprubí
Cardiovascular Research Group, Sant Joan de Deu Research Institute, BCNatal-Barcelona Center for Maternal Fetal and Neonatal Medicine, Hospital Sant Joan de Déu-Hospital Clinic, University of Barcelona, 08950 Barcelona, Spain
Joan Sanchez-de-Toledo
Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
Pediatric cardiac surgery induces an increased oxidative stress (OS) response. Increased OS is associated with poor neurologic outcomes in neonatal populations with similar patterns of brain injury. We investigated OS and brain injury in infants undergoing heart surgery. Patients 6 months or younger, undergoing cardiac surgery with or without cardiopulmonary bypass (CPB), were included in this prospective, observational study. Patients were divided into infant (30 days–6 months) and neonatal (p = 0.0261). There was also a correlation between immediate post-surgery levels of 8-iso-PGF2α and intra-surgery seizure burden (rho = 0.4285, p = 0.0205). Patients with an abnormal neurological evaluation had increased levels of S100B 72 h after surgery (p = 0.048). 8-iso-PGF2α levels 24 h after surgery were also related to abnormal neurologic outcomes. Levels of 8-iso-PGF2α following pediatric cardiac surgery are associated with several indicators of brain injury including brain damage biomarkers, intra-operative seizures, and abnormal neurological evaluation at follow-up, suggesting the importance of oxidative stress response in the origin of brain damage in this population.
