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The Annals of Thoracic Surgery, Vol 58, 478-482, Copyright © 1994 by The Society of Thoracic Surgeons

ARTICLES

Effect of cardiopulmonary bypass on the circulating level of soluble GMP-140

H Komai and SG Haworth
Vascular Biology and Pharmacology Unit, Institute of Child Health, London, England.

Soluble GMP-140 can prevent the adhesion of activated neutrophils to endothelium in vitro. Because cardiopulmonary bypass causes neutrophil- endothelial interaction, the plasma level of soluble GMP-140 was measured using an enzyme immunoassay system in 32 children undergoing intracardiac repair of congenital heart disease. They had either a high, low, or normal pulmonary blood flow (n = 13, 12, and 7 respectively). Because activated platelets are a source of GMP-140, the plasma beta-thromboglobulin level was also measured. Blood was sampled before, during, and for 24 hours after cardiopulmonary bypass. Plasma levels of both soluble GMP-140 and beta-thromboglobulin increased after the onset of cardiopulmonary bypass in all patients but for both substances the increase was greater in those with a low pulmonary blood flow (p < 0.05 for all comparisons). The sum total of soluble GMP-140 values during and after operation was correlated negatively with the preoperative mean pulmonary arterial pressure (p < 0.05 for all time intervals). GMP-140 level correlated with the plasma beta- thromboglobulin level (r = 0.5, p < 0.05). This work supports the contention that soluble GMP-140 is released from activated platelets during cardiopulmonary bypass, the level being particularly high in those who had intrinsically abnormal platelets preoperatively in association with a low pulmonary blood flow. Patients with a high pulmonary blood flow, who are more susceptible to endothelial cell injury, may be less well protected by soluble GMP-140.

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