Von Willebrand factor plasma levels depend on rate of hypothermia in paediatric cardiopulmonary bypass

Leszek Bęc¹, Maciej A. Karolczak¹, Barbara Motylewicz¹, Ewa Rogala²

Summary
Background. The use of a cardiopulmonary bypass (CPB) is associated with a risk of endothelial damage. Von Willebrand factor (vWf) is a marker of necroses endothelial cells. High levels of vWf increase the of postoperative complications and morality. Our objective was to find any correlation between cardiopulmonary bypass and plasma levels of vWf I paediatric patients who had been operated on for congenital heart defects.
Method. 20 patients with simple congenital heart defects were operated on using a cardiopulmonary bypass. Arterial blood was sampled after induction of anesthesia, 5 minutes after commencing CPB, and at 1 hour and 3 hours after surgery finished. The plasma levels of von Willebrand factor were measured and compared to selected clinical findings? What? How? Boes thin mean known clinical data! It so, what?
Results. Von Willebrand factor plasma levels were significantly elevated in all patients 1 hour and 3 hours after surgery. We found no correlation between vWf levels and type of defect, CPB duration, aortic cross clamp ing, or reperfusion time. However, we were able to demonstrate that the observed elevation of vWF levels was almost 4-fold higher in patients cooled down to lower temperatures (15 pts; mean rectal value 27.64ą0.7°C) than in 5 patients (mean rectal temp. 30.74ą1.56°C) where only slight elevation was found. There were no differences in He postoperative course of these patients. All patients were discharged from hospital 10ą3 days after operation (median 9 days).
Conclusion. Paediatric hypothermic cardiopulmonary bypass is associated with a significant elevation of von Willebrand factor plasma levels. It seems that the augmentation of vWf values could be independently associated with the rate of hypothermia.

To jest tylko fragment artykułu. Aby przeczytać całość, przejdź do Czytelni medycznej.