Evidence for Development of Capillary Leak Syndrome Associated with Cardiopulmonary Bypass in Pediatric Patients with the Homozygous C4A Null Phenotype

摘要: Background: The mechanism of postoperative capillary leak syndrome related to cardiopulmonary bypass (CPB) is unknown. authors hypothesized that C4 gene polymorphism might be involved in the development because complement activation associated with CPB and protamine administration, two isotypes (C4A C4B) differ their biochemical functional properties after activation. Methods: One hundred fifty-six pediatric patients referred for elective cardiac surgery were included study. isotype studies performed plasma samples obtained before surgery, use agarose gel immunofixation crossed immunoelectrophoresis. Five possible phenotype groups observed, which abbreviated as follows: (1) AABB no detectable null alleles, (2) A0BB a single allele (heterozygous) at C4A locus, (3) 00BB homozygous allele, (4) AAB0 C4B (5) AA00 allele. classified into five according phenotypes. Before 1 h CPB, protein was measured biuret test kit. Plasma colloid osmotic pressure determined membrane osmometer. Evans blue dye used measure volume, serum protein, intravenous pool, transvascular escape rate dye. Results: Of 156 enrolled, 80 assigned group, 28 7 31 10 At concentrations averaged 3.6 0.4 g/dl phenotype; this value significantly lower (P < 0.01) than other changes pool comparable change concentration. 11.5 1.3%/h higher Conclusions: In study, induced by occurred only phenotype. CAPILLARY defined shift fluid from intravascular interstitial space. This characterized generalized edema formation ascites caused an increase microvascular permeability proteins (PPs), inflammatory cytokines system. Cardiopulmonary produces inflammation. 2,3 inflamma