Soluble L-selectin plasma concentrations in infants undergoing heart surgery: no association with capillary leak syndrome or need for respiratory support

Objective: In critical care patients at risk of developing the acute respiratory distress syndrome (ARDS), low soluble L-selectin (sCD62L) plasma concentrations have been shown to be associated with progression to ARDS and prolonged subsequent mechanical ventilation. This study aimed to determine the usefulness of sCD62L plasma concentrations to identify infants undergoing cardiovascular surgery who are at risk for postoperative pulmonary dysfunction and capillary leaks. Design: Serial measurements of sCD62L plasma concentrations in a cohort of infants with congenital heart disease before, during, and after surgery for 4 consecutive days. Setting and patients: Infants aged 3-337 days undergoing cardiovascular surgery with (N = 27) or without (N = 12) cardiopulmonary bypass in a tertiary care center. Results: sCD62L concentrations before surgery showed a strong correlation with the infant's age (r = 0.77, p < 0.001). During surgery, sCD62L levels dropped from 9.0 +/- 0.7 to 5.6 +/- 0.4 nmol/l (mean +/- SEM; p < 0.001). The minimum sCD62L concentration during and after surgery did not differ between infants operated upon with or without cardiopulmonary bypass (p > 0.1) or in infants who did (N = 10) or did not (N = 29) develop capillary leak syn drome. Whereas capillary leak syndrome was associated with prolonged mechanical ventilation (p < 0.01), there was no relationship between sCD62L concentrations at baseline or at any time thereafter and number of hours on the ventilator (p > 0.1). Conclusion: sCD62L concentrations before or after surgery are not apt to identify infants at increased risk of prolonged mechanical ventilation.