{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:41:24Z","timestamp":1780360884175,"version":"3.54.1"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,7,18]],"date-time":"2024-07-18T00:00:00Z","timestamp":1721260800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,7,18]],"date-time":"2024-07-18T00:00:00Z","timestamp":1721260800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"FAPESP \u2013 Foundation for Research Support of the State of S\u00e3o Paulo, S\u00e3o Paulo, Brazil","award":["Grants #2015\/21587-5 and #2019\/18789-5."],"award-info":[{"award-number":["Grants #2015\/21587-5 and #2019\/18789-5."]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>Although Down syndrome (DS) is considered a risk factor for hemodynamic instabilities (mainly pulmonary hypertension\u2013PH) following surgery for congenital cardiac communications, many DS patients do surprising well postoperatively. We prospectively analyzed perioperative factors for a possible correlation with post-cardiopulmonary bypass (CPB) inflammatory reaction and postoperative PH in pediatric subjects. Sixty patients were enrolled (age 3 to 35\u00a0months), 39 of them with DS. Clinical and echocardiographic parameters (anatomical and hemodynamic) were computed preoperatively. Pulmonary and systemic mean arterial pressures (PAP and SAP) were assessed invasively intra and postoperatively. Immediate postoperative PAP\/SAP ratio (PAP\/SAP<jats:sub>IPO<\/jats:sub>) and the behavior of pressure curves were selected as primary outcome. Serum levels of 36 inflammatory proteins were measured by chemiluminescence preoperatively and 4\u00a0h post CPB. Of all factors analyzed, peripheral oxygen saturation (O<jats:sub>2<\/jats:sub>Sat, bedside assessment) was the only preoperative predictor of PAP\/SAP<jats:sub>IPO<\/jats:sub> at multivariate analysis (p\u2009=\u20090.007). Respective values in non-DS, DS\/O<jats:sub>2<\/jats:sub>Sat\u2009\u2265\u200995% and DS\/O<jats:sub>2<\/jats:sub>Sat\u2009&lt;\u200995% subgroups were 0.34 (0.017), 0.40 (0.027) and 0.45 (0.026), mean (SE), p\u2009=\u20090.004. The difference between non-DS and DS groups regarding postoperative PAP curves (upward shift in DS patients, p\u2009=\u20090.015) became nonsignificant (p\u2009=\u20090.114) after adjustment for preoperative O<jats:sub>2<\/jats:sub>Sat. Post-CPB levels of at least 5 cytokines were higher in patients with O<jats:sub>2<\/jats:sub>Sat\u2009&lt;\u200995% <jats:italic>versus<\/jats:italic> those at or above this level, even within the DS group (p\u2009&lt;\u20090.05). Thus, a baseline O<jats:sub>2<\/jats:sub>Sat\u2009&lt;\u200995% representing pathophysiological phenomena in the airways and the distal lung, rather than DS in a broad sense, seems to be associated with post-CPB inflammation and postoperative PH in these patients.<\/jats:p>","DOI":"10.1038\/s41598-024-67097-4","type":"journal-article","created":{"date-parts":[[2024,7,18]],"date-time":"2024-07-18T16:03:02Z","timestamp":1721318582000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Down syndrome and postoperative hemodynamics in patients undergoing surgery for congenital cardiac communications"],"prefix":"10.1038","volume":"14","author":[{"given":"Eloisa Sass\u00e1","family":"Carvalho","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliano Gomes","family":"Penha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nair Yukie","family":"Maeda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly Cristina O.","family":"Abud","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Francilene S.","family":"Souza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia R. P.","family":"Castro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johnny X.","family":"dos Santos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana","family":"Pereira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio Augusto","family":"Lopes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,7,18]]},"reference":[{"issue":"21","key":"67097_CR1","doi-asserted-by":"publisher","first-page":"2037","DOI":"10.1161\/CIR.0000000000000329","volume":"132","author":"SH Abman","year":"2015","unstructured":"Abman, S. H. et al. American heart association council on cardiopulmonary, critical care, perioperative and resuscitation; council on clinical cardiology; council on cardiovascular disease in the young; council on cardiovascular radiology and intervention; council on cardiovascular surgery and anesthesia; and the american thoracic society. Pediatric pulmonary hypertension: Guidelines from the American heart association and American thoracic society. Circulation 132(21), 2037\u20132099 (2015).","journal-title":"Circulation"},{"key":"67097_CR2","first-page":"209","volume-title":"Pediatric Pulmonary Hypertension","author":"I Adatia","year":"2011","unstructured":"Adatia, I. Pulmonary hypertension and postoperative congenital heart disease. 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The Funding section now reads: \u201cThis study was supported by FAPESP\u2014Foundation for Research Support of the State of S\u00e3o Paulo, S\u00e3o Paulo, Brazil, Grants #2015\/21587-5 and #2019\/19289-7\u201d","order":6,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"16612"}}