ABSTRACT
Background: The inflammatory response due to cardiopulmonary bypass (CBP) activates
different inflammatory pathways that affect multiple organs. Dexmedetomidine is proved to
affect inflammatory marker production.
Objectives: Evaluation of the effect of Dexmedetomidine on the inflammatory response
associated with pediatric open-heart surgery using interleukin-6 (IL-6) and interferon-gamma
(INF-ɤ) levels.
Methods: 61children aged between one to 8 years undergoing elective repair of non-cyanotic
congenital heart disease with CPB were randomly assigned into two groups. The control group
(31 patients) received normal saline, whereas the Dex group (30 patients) received an initial
bolus of Dexmedetomidine 0.5 μg/kg followed immediately by infusion of 0.5 μg/kg/hr
continued till the end of CPB. The level of IL-6 and INF-ɤ was measured. Hemodynamic, ICU,
and hospital data were recorded.
Results: IL-6 and INF -ɤ levels were increased significantly with time in control group, with no
increase in their levels in the Dex group. They were significantly lower in the Dex group
compared to the control group in samples taken during bypass, 6 h and 24 h after the
operation (the end of surgical procedure). There was a significant difference between the
groups regarding inotropic score and mechanical ventilation. There was no significant difference
between the groups regarding complications, duration of ICU or hospital stay.
Conclusion: The use of Dexmedetomidine in pediatric cardiac surgery for non-cyanotic heart
disease had significantly attenuated the inflammatory response. It was useful in decreasing the
level of inflammatory mediators, inotropic support, and duration of mechanical ventilation, but
not the ICU or hospital stay.
Trial registration: https://clinicaltrials.gov. (Identifier: NCT03163238).