Observational studyFrontiers in immunology2025
The distinct contribution of sternotomy to the systemic inflammatory response during children's heart surgery.
Observational study in Frontiers in immunology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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8 authors.
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Abstract
Background: Sternotomy provides access to the mediastinum, heart and great vessels for congenital cardiac surgery in children. The contribution of this incision to the systemic inflammatory response during open-heart surgery, particularly in combination with the complement-mediated response to cardiopulmonary bypass (CPB), is unknown. This study aimed to characterize the inflammatory mediator profile of sternotomy and contrast that with CPB-associated inflammation. Methods: This study is a Results: Compared to baseline, all 16 cytokines and chemokines assessed increased through the sternotomy phase, while complement and adhesion molecules were static or decreased. The most active mediators were IL-1β (3.3x median fold increase), CXCL2 (3.3x), IL-6 (2.6x), IL-10 (2.6x), GM-CSF (2.3x), IL-1α (2.2x) and IL-2 (1.7x). The PCA-HCPC showed three statistically significant clusters, cluster 1 grouped cytokines and chemokines with the sternotomy phase, while complement mediators and adhesion molecules were in separate clusters. In contrast to the CPB exposure, sternotomy showed a predominant contribution of TNF, IL-1α, IL-1β, IL-2, TRAIL, CCL3, CCL4, CXCL1, CXCL2 and GM-CSF to the systemic inflammatory response. Conclusions: Sternotomy and related tissue trauma produce a distinct systemic inflammatory mediator profile, consisting of pro-inflammatory cytokines and chemokines but not complement. The mediators IL-6, CXCL8, IL-1Ra and IL-10 are sequentially induced by both sternotomy and CPB, representing sequential immunologic stimulation during the cardiac operation.
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