Oxidative Stress and Indicators of Brain Damage Following Pediatric Heart Surgery

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...

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Bibliographic Details
Published in:	Antioxidants Vol. 11; no. 3; p. 489
Main Authors:	Cañizo Vázquez, Débora, Hadley, Stephanie M, Pérez Ordóñez, Marta, Lopez-Abad, Miriam, Valls, Anna, Viñals, Marta López, Moscoso, Bosco A, Benito Fernandez, Sergio, Camprubí-Camprubí, Marta, Sanchez-de-Toledo, Joan
Format:	Journal Article
Language:	English
Published:	Switzerland MDPI AG 28-02-2022 MDPI
Subjects:	8-iso-prostaglandin F2α Age Biomarkers Brain damage Brain injury Congenital diseases COVID-19 Creatinine EEG Electroencephalography Enzymes Heart Heart surgery Infants Neonates Newborn babies Oxidative stress Patients pediatric cardiac surgery Pediatrics Premature babies Prostaglandin F2a S100B protein Seizures Urine United States > US pediatric cardiac surgery S100B protein 8-iso-prostaglandin F2α oxidative stress
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Summary:	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 (<30 days) groups for analysis. Urine OS biomarker 8-iso-prostaglandin F2α (8-iso-PGF2α) was quantified pre-surgery and at 0 and 24 h post-surgery. A serum brain damage biomarker S100B protein was also measured pre-surgery and at 0 and 72 h post-surgery. Amplitude-integrated electroencephalography during surgery was analyzed. Neuropsychological evaluation using the Bayley III or Vineland test was performed in all patients at 24 months of age. Sixty-two patients were included, 44 of whom underwent follow-up neurologic evaluation. 8-iso-PGF2α and S100B levels were increased after surgery. Postoperative levels of S100B were positively correlated with 8-iso-PGF2α levels 24 h after surgery (rho = 0.5224; 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.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 These authors contributed equally to this work.
ISSN:	2076-3921 2076-3921
DOI:	10.3390/antiox11030489