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@article{Correia:2015:10.1097/CCM.0000000000000982,
author = {Correia, GDS and Ng, KW and Wijeyesekera, A and Gala-Peralta, S and Williams, R and MacCarthy-Morrogh, S and Jimenez, B and Inwald, D and Macrae, D and Frost, G and Holmes, E and Pathan, N},
doi = {10.1097/CCM.0000000000000982},
journal = {Critical Care Medicine},
pages = {1467--1476},
title = {Metabolic Profiling of Children Undergoing Surgery for Congenital Heart Disease},
url = {http://dx.doi.org/10.1097/CCM.0000000000000982},
volume = {43},
year = {2015}
}

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TY  - JOUR
AB  - Inflammation and metabolism are closely interlinked.Both undergo significant dysregulation following surgery for congenitalheart disease, contributing to organ failure and morbidity.In this study, we combined cytokine and metabolic profilingto examine the effect of postoperative tight glycemic controlcompared with conventional blood glucose management onmetabolic and inflammatory outcomes in children undergoingcongenital heart surgery. The aim was to evaluate changes in keymetabolites following congenital heart surgery and to examinethe potential of metabolic profiling for stratifying patients in termsof expected clinical outcomes.Design: Laboratory and clinical study.Setting: University Hospital and Laboratory.Patients: Of 28 children undergoing surgery for congenital heartdisease, 15 underwent tight glycemic control postoperatively and13 were treated conventionally.Interventions: Metabolic profiling of blood plasma was undertakenusing proton nuclear magnetic resonance spectroscopy. A panel ofmetabolites was measured using a curve-fitting algorithm. Inflammatorycytokines were measured by enzyme-linked immunosorbentassay. The data were assessed with respect to clinical markers ofdisease severity (Risk Adjusted Congenital heart surgery score-1,Pediatric Logistic Organ Dysfunction, inotrope score, duration ofventilation and pediatric ICU-free days).Measurements and Main Results: Changes in metabolic andinflammatory profiles were seen over the time course from surgeryto recovery, compared with the preoperative state. Tight glycemiccontrol did not significantly alter the response profile. We identifiedeight metabolites (3-d-hydroxybutyrate, acetone, acetoacetate,citrate, lactate, creatine, creatinine, and alanine) associated withsurgical and disease severity. The strength of proinflammatoryresponse, particularly interleukin-8 and interleukin-6 concentrations,inversely correlated with PICU-free days at 28 days. The interleukin-6/interleukin-10ratio directly correlated wi
AU  - Correia,GDS
AU  - Ng,KW
AU  - Wijeyesekera,A
AU  - Gala-Peralta,S
AU  - Williams,R
AU  - MacCarthy-Morrogh,S
AU  - Jimenez,B
AU  - Inwald,D
AU  - Macrae,D
AU  - Frost,G
AU  - Holmes,E
AU  - Pathan,N
DO  - 10.1097/CCM.0000000000000982
EP  - 1476
PY  - 2015///
SN  - 1530-0293
SP  - 1467
TI  - Metabolic Profiling of Children Undergoing Surgery for Congenital Heart Disease
T2  - Critical Care Medicine
UR  - http://dx.doi.org/10.1097/CCM.0000000000000982
UR  - http://hdl.handle.net/10044/1/27773
VL  - 43
ER  -

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