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- Title
Intercellular adhesion molecule (ICAM-1) response after major neonatal surgery.
- Authors
Koga, Hiroyuki; Kobayashi, Hiroyuki; Yamataka, Atsuyuki; Lane, Geoffrey J.; Miyano, Takeshi
- Abstract
Surgical stress induces systemic endocrine-metabolic responses that influence the function of endothelial cells (EC) to cause various systemic reactions. Intercellular adhesion molecule (ICAM)-1 is an adhesion molecule that plays an important role in inflammation, and increased expression of ICAM-1 on EC is a reflection of EC activation. In this study, we investigated the ICAM-1 response to surgical stress in neonates undergoing major surgery. Fifteen neonates (mean age at surgery: 3.5±1.2 days) were divided into two groups according to indications for surgery: Group I: Congenital diaphragmatic hernia without persistent pulmonary hypertension ( n=5); Group II: Gastrointestinal surgery [ n=10: duodenal atresia ( n=3), intestinal atresia ( n=6), and esophageal atresia ( n=1)]. Serum samples were obtained preoperatively, immediately after completion of surgery (time zero), and 24, 48, 72, 96, and 120 h after surgery to measure ICAM-1 levels using an enzyme-linked immunosorbent assay, C-reactive protein (CRP), and white blood cell count (WBC). Postoperative recovery was uneventful in all cases. ICAM-1 levels in both groups increased significantly within 24 h of surgery (Group I: P=0.0038, Group II: P=0.0320). In Group I, ICAM-1 peaked 72 h postoperatively while in Group II it continued to rise until 96 h postoperatively. The difference between peak levels reached was not significant. CRP was first detected 24 h postoperatively in both groups and continued to increase until 48 h postoperatively. Again, the difference between peak levels reached was not significant. No significant changes in WBC were observed in either group. We found that ICAM-1 increases in response to surgical stress in neonates, although there was no significant difference in levels. However, surgical stress as represented by serum ICAM-1 would appear to last longer with intestinal surgery than with non-intestinal surgery. Further research is required to establish the usefulness of ICAM-1 as an easily detectable substance associated with endothelial damage that reflects the host’s response to major surgical stress.
- Subjects
CELL adhesion molecules; NEONATAL surgery; DESMOSOMES; HEMIDESMOSOMES; INFLAMMATION
- Publication
Pediatric Surgery International, 2005, Vol 21, Issue 9, p695
- ISSN
0179-0358
- Publication type
journal article
- DOI
10.1007/s00383-005-1494-6