8 May 2015
A new study has found that blood markers could be used to predict the outcome of heart surgery with infant patients.
Published in the journal Critical Care Medicine, the research looked at children undergoing surgery for congenital heart disease. It found that analysing metabolites in the blood made it possible to predict the outcome of the procedure.
Researchers at Royal Brompton Hospital followed 28 children who had a median age of 6.6 months who were undergoing the procedure. The babies were part of a larger trial looking at management of blood sugar in 1,300 critically ill children, meaning 15 of the children had their blood sugar levels tightly controlled using insulin. The other 13 underwent the standard blood sugar control treatment.
For the study, which was funded by the British Heart Foundation (BHF), the team gathered blood samples from before surgery through to 48 hours afterwards. These were then analysed using nuclear magnetic resonance (NMR).
The researchers found a link between certain metabolites found in the blood and a child's clinical outcome. The more ketone bodies, which are produced when the body does not have enough insulin in the blood and help break down fat instead of sugar for energy, the better the outcomes were.
However, the presence of other metabolites such as citrate, lactate and alanine correlated with poorer outcomes.
In contrast, the team found no difference in clinical outcome between those patients whose blood sugar levels were tightly controlled and those who received the standard blood sugar control treatment.
Dr Nazima Pathan, from the Department of Paediatrics at the University of Cambridge and lead author of the study, said: "We've shown that the presence of certain molecules in a child's blood following heart surgery can help predict how well a child will recover in the crucial hours and days immediately following surgery. This opens up the possibility of us being able to identify those children at greatest risk following surgery and target them with the appropriate critical care management."
Congenital heart disease is relatively common, affecting between four and 14 babies in every 1,000 live births. Around a third of these children will need surgery during early childhood but this can cause complications, affecting inflammation, the endocrine system and metabolism itself.
Professor Jeremy Pearson, associate medical director at the British Heart Foundation, said: "This study has shown a possible new way to assess children recovering from congenital heart surgery by measuring certain molecules in the blood. By identifying children who might be struggling sooner, doctors could intervene with treatments earlier. More research is now required to see whether such a test could give doctors that early warning sign that urgent treatment is needed."
Posted by Jeanette Royston
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