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. 2021 Jun 24;11(7):1149.
doi: 10.3390/diagnostics11071149.

Perioperative GABA Blood Concentrations in Infants with Cyanotic and Non-Cyanotic Congenital Heart Diseases

Angela Satriano  1 , Alessandro Varrica  1 , Alessandro Frigiola  1 , Alessandro Graziosi  2 , Caterina Di Battista  2 , Adele Patrizia Primavera  2 , Giacomo Centini  3 , Antonio Maconi  3 , Chiara Strozzi  3 , Antonio D W Gavilanes  4 , Luc J Zimmermann  4 , Hans J S Vles  4 , Diego Gazzolo  2
Affiliations

Perioperative GABA Blood Concentrations in Infants with Cyanotic and Non-Cyanotic Congenital Heart Diseases

Angela Satriano et al. Diagnostics (Basel). .

Abstract

Perioperative stress detection in children with congenital heart disease (CHD), particularly in the brain, is still limited. Among biomarkers, γ-amino-aminobutyric acid (GABA) assessment in biological fluids appears to be promising for its regulatory action on the cardiovascular and cerebral systems. We aimed to investigate cyanotic (C) or non-cyanotic (N) CHD children for GABA blood level changes in the perioperative period. We conducted an observational study in 68 CHD infants (C: n = 33; N: n = 35) who underwent perioperative clinical, standard laboratory and monitoring parameter recordings and GABA assessment. Blood samples were drawn at five predetermined time-points before, during and after surgery. No significant perioperative differences were observed between groups in clinical and laboratory parameters. In C, perioperative GABA levels were significantly lower than N. Arterial oxygen saturation and blood concentration significantly differed between C and N children and correlated at cardiopulmonary by-pass (CPB) time-point with GABA levels. The present data showing higher hypoxia/hyperoxia-mediated GABA concentrations in C children suggest that they are more prone to perioperative cardiovascular and brain stress/damage. The findings suggest the usefulness of further investigations to detect the "optimal" oxygen concentration target in order to avoid the side effects associated with re-oxygenation during CPB.

Keywords: GABA; brain; cardiopulmonary by-pass; children; cooling; newborn; reoxygenation.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Arterial oxygen partial pressure levels (PaO2, mmHg) expressed as median and 5–95° centiles (•) ranges in cyanotic (C) and acyanotic (N) congenital heart disease children measured before the surgical procedure (T0); during the surgical procedure after sternotomy before cardiopulmonary bypass (CPB) (T1); at the end CPB (T2); at the end of the surgical procedure (T3); and at 24 h after the surgical procedure (T4). PaO2 significantly differed in C infants at T0, T1 and T4 monitoring time-points while no differences (p > 0.05, for all) were observed at T2-T4 time-points.
Figure 2
Figure 2
Cerebral regional oxygenation status (crSO2) expressed as median and 5–95° centiles ranges in cyanotic (C; •) and non-cyanotic (N; o) congenital heart disease children measured before the surgical procedure (T0); during the surgical procedure after sternotomy before CPB (T1); at the end CPB (T2); at the end of the surgical procedure (T3); and at 24 h after the surgical procedure (T4). crSO2 was significantly lower (p < 0.01, for all) in C infants at all monitoring time-points.
Figure 3
Figure 3
GABA blood concentrations (pg/mL) expressed as median and interquartile ranges in cyanotic (C; o) and non-cyanotic (N; •) congenital heart disease children measured before the surgical procedure (T0); during the surgical procedure after sternotomy before CPB (T1); at the end CPB (T2); at the end of the surgical procedure (T3), and at 24 h after the surgical procedure (T4). In C GABA levels when compared with N children were higher (p < 0.001) at T0; no differences (p > 0.05) at T1; lower (p < 0.01) at T2; and no differences (p > 0.05) at T3; lower (p < 0.01) at T4.
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