PRESEPSIN LEVEL IN NEONATES AND INFANTS IN THE FIRST YEAR OF LIFE WITH CONGENITAL HEART DISEASES BEFORE AND AFTER CARDIAC SURGERIES
Objective. To assess the diagnostic and prognostic value of presepsin (PSP) study in the perioperative period as a predictor of infectious-septic complications progression and to evaluate the combination intensive therapy carried out among the neonates and infants in the first year of life after cardiac surgeries. Material and methods. Neonates ( n =39) and infants in the first year of life ( n =76) with congenital heart diseases (CHD) after cardiac surgeries were included in the study. The results of the selective adsorption of lipopolysaccharide (LPS) procedures applied to 10 sepsis cases after complicated CHD correction are presented in the article. Basic clinical biochemical parameters, endotoxin activity assay (EAA) and presepsin were measured in the dynamics (before the surgery, on the 1st day, 10 days after the surgery). Results. No infants had clinical laboratory signs of infection before the surgery. After the cardiac surgery the PSP level became significantly higher, and it had a tendency to decline during smooth postoperative period. High level of presepsin - 914 (673; 2812) pg/mL was found in the patients with infectious complications, particularly in those who had LPS-adsorption in their intensive therapy. Adequate combination therapy including LPS-adsorption contributed to patients' clinical state improvement and normalization of laboratory parameters, of presepsin in particular. The survival rate within 28 days accounted for 90%. 3 (4%) out of 76 infants in the first year of life with CHD and without other clinical laboratory signs of infection had 422.5 (337.5; 824.4) pg/mL concentration of presepsin before the surgery. After the surgery the infants demonstrated infectious complications. Conclusion. Study results let us assume that presepsin characteristics included in the laboratory tests' complex can contribute to accurate and early detection of sepsis risk group and to efficiency control of the therapy.