CHILDREN UNDERGOING OPEN-HEART SURGERY

接受心脏直视手术的儿童

• 批准号: 7374411
• 负责人: Mark Twite
• 金额: $ 1.38万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-04-24 至 2007-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7374411
• 关键词: children; heart surgery; lung

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Congenital heart disease affects 1% of children worldwide. Many of these heart defects are amenable to surgical correction, with approximately 500,000 children undergoing open heart surgery every year in the USA. One of the major causes of morbidity and mortality associated with open heart surgery in children is the systemic inflammatory response syndrome (SIRS). This syndrome causes end-organ dysfunction following cardiopulmonary bypass (CPB). In children, the lungs are particularly vulnerable to post-CPB dysfunction and this may manifest as acute pulmonary hypertensive crisis and acute lung injury. It is unclear why some children will undergo an exaggerated inflammatory response to CPB and others do not. It is also difficult to predict those children that will develop post-operative pulmonary dysfunction. Possible factors contributing towards the differences in the SIRS and post-CPB lung dysfunction in children include: genetic predisposition, the pre-existing inflammatory state of the child, and the type of cardiac lesion. Children with cyanotic as opposed to acyanotic heart lesions may already have an inflammatory response that is upregulated secondary to chronic hypoxia. While there are numerous markers of the SIRS, none of these are immediately available to the clinician and the links between these markers and actual biological dysfunction are uncertain. One potential early marker of lung dysfunction is exhaled nitric oxide. The purpose of this study is to examine whether exhaled nitric oxide in children undergoing CPB could be an early marker of lung dysfunction for the cardiac anesthesiologist and be used to identify at risk children to potentially prevent further lung damage.

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。先天性心脏病影响全世界1%的儿童。这些心脏缺陷中的许多可以通过手术矫正，在美国每年约有50万儿童接受心脏直视手术。全身炎症反应综合征（SIRS）是导致儿童心脏直视手术发病率和死亡率的主要原因之一。这种综合征导致心肺转流（CPB）后终末器官功能障碍。在儿童中，肺特别容易受到CPB后功能障碍的影响，这可能表现为急性肺动脉高压危象和急性肺损伤。目前还不清楚为什么有些儿童会对CPB产生过度的炎症反应，而另一些则不会。也很难预测哪些儿童会发生术后肺功能障碍。导致儿童SIRS和CPB后肺功能障碍差异的可能因素包括：遗传易感性、儿童预先存在的炎症状态和心脏病变类型。与非紫绀型心脏病变相反，紫绀型心脏病变的儿童可能已经存在继发于慢性缺氧的炎症反应。虽然有许多SIRS的标志物，但临床医生无法立即获得这些标志物，并且这些标志物与实际生物功能障碍之间的联系尚不确定。肺功能障碍的一个潜在早期标志物是呼出的一氧化氮。本研究的目的是检查接受CPB的儿童呼出的一氧化氮是否可以作为心脏麻醉师肺功能障碍的早期标志物，并用于识别有风险的儿童，以防止进一步的肺损伤。