Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jun;161(6):2180-2190.
doi: 10.1016/j.jtcvs.2020.05.108. Epub 2020 Jun 29.

Effect of perfusate oxygenation on inflammatory response in congenital heart disease children from low versus high altitude

Hong Liu  1 , Yi-Jin Hu  2 , Si-Qiang Zheng  2 , Tao Chen  2 , Zhi-Hua Zeng  2 , Dong-Dong Wu  2 , Shuang Zhao  2 , Bin Zeng  2 , Zhi-Gang Liu  2 , Yong-Feng Shao  3 ; TedaICH Cardiovascular Discovery Group
Affiliations
Free article

Effect of perfusate oxygenation on inflammatory response in congenital heart disease children from low versus high altitude

Hong Liu et al. J Thorac Cardiovasc Surg. 2021 Jun.
Free article

Abstract

Objective: To examine the altitude differences in the optimal perfusate oxygenation (PpO2) in patients who underwent cardiac surgery.

Methods: We included children (aged 1 month to 18 years) with congenital heart diseases surgically repaired between 2012 and 2018. We included only patients who underwent cardiac surgery with arrested heart cardiopulmonary bypass. Primary outcome was severe systemic inflammatory response syndrome (SIRS). Logistic regression was used to evaluate the association between arterial PpO2 on continuous and categorical scales and severe SIRS by altitude. We established PpO2 thresholds that equated to a risk probability of roughly 0.185 or greater for developing severe SIRS in each group of altitude.

Results: Among 3918 patients from low altitudes and 2384 from high altitudes, high-altitude patients were older (median, 42.3 [interquartile range 22.8-75.8] vs 37.1 [17.7-69.1] months, P < .001) and had lower arterial PpO2 (289 [237-342] vs 301 [246-362] mm Hg, P < .001). Greater PpO2 was associated with increased risk of severe SIRS overall (adjusted odds ratio, 1.221 [95% confidence interval, 1.167-1.278] per standard deviation increase), with a stronger monotonic associations for low-altitude patients than for high-altitude patients (adjusted odds ratio, 1.302 [95% confidence interval, 1.229-1.379] vs adjusted odds ratio, 1.083 [95% confidence interval, 1.003-1.170] per standard deviation increase) (Pinteraction = .0003). A PpO2 level of 310 mm Hg identified low-altitude patients with a risk probability of roughly 0.185 or greater of severe SIRS, whereas the cutoffs ranged from 200 mm Hg to 325 mm Hg for high-altitude patients.

Conclusions: This study suggests altitude differences in the association of arterial PpO2 with inflammatory response following pediatric cardiac surgery.

Keywords: cardiopulmonary bypass; congenital heart diseases; systemic inflammatory response syndrome.

PubMed Disclaimer

Comment in

Publication types