• Peter Gessler, Juerg Pfenninger, Jean-Pierre Pfammatter, Thierry Carrel, and Clemens Dahinden.
• Department of Pediatric Intensive Care & Neonatology, University Children's Hospital, Steinwiesstrasse 75, 8032 Zurich, Switzerland. peter.gessler@kispi.unizh.ch
• Intensive Care Med. 2002 Dec 1; 28 (12): 1786-91.

ObjectiveTo determine whether the activation state of polymorphonuclear neutrophils (PMNs) and monocytes contributes to the inflammatory response after cardiopulmonary bypass (CPB) in pediatric cardiac surgery.DesignObservational prospective clinical study.SettingPediatric intensive care unit of a university hospital.PatientsTwenty pediatric patients before and after open heart surgery with CPB.MeasurementsCell counts of circulating PMNs and monocytes as well as phenotypic and functional analysis of these cells, and plasma levels of myeloperoxidase.ResultsLevels of myeloperoxidase (a marker of PMN degranulation) were significantly elevated after CPB (2.9+/-1.6 ng/ml before CPB versus 13.7+/-6.5 ng/ml after CPB, p=0.0001). However, PMN function, as measured by surface expression of CD11b/CD18 and phagocytic respiratory burst, was reduced. In contrast, the phagocytic respiratory burst of circulating monocytes was increased in some patients and there was a correlation with the increase of monocyte cell count after CPB (r=0.63, p=0.015).ConclusionsAfter the end of CPB, there was an ongoing inflammatory process. In particular, there was an activation of monocytes after the end of CPB.

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