Changes in neutrophil CD11b/CD18 andl-selectin expression and release of interleukin 8 and elastase in paediatric cardiopulmonary bypass

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Abstract
Children undergoing cardiopulmonary bypass (CPB) surgery for congenital heart defects develop an acute post-operative capillary leak which may be due to endothelial injury inflicted by adherent neutrophils (PMN). Direct immunofluorescence and flow cytometry were used to measure CD11a/CD18, CD11b/CD18 andl-selectin (l-s) expression on circulating PMN in CPB circuits containing human blood and in children undergoing CPB.In vitro, a general rise in CD11b/CD18 expression over 2h contrasted with complete loss ofl-s in a small but progressively increasing proportion of PMN. Marked but inconsistent changes in CD11b/CD18 andl-s were observedin vivo, in conjunction with fluctuations in circulating PMN count. Circulating IL-8 was detected starting at rewarming from hypothermia and reperfusion of the heart and lungs with a simultaneous, closely correlated rise in both PMN count and circulating elastase. IL-1 and TNF were not detected. These studies demonstrate changes in the pathways of PMN-endothelial interaction during and after CPB.