ArticleThe Journal of pediatrics2017
Alkaline Phosphatase in Infant Cardiopulmonary Bypass: Kinetics and Relationship to Organ Injury and Major Cardiovascular Events.
Article in The Journal of pediatrics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 23 citations in OpenAlex.
- Alkaline Phosphatase Activity and Endotoxemia After Infant Cardiothoracic Surgery.Shock (Augusta, Ga.) · 2019Trial
- The Gut Microbiome in Congenital Heart Disease: Dysbiosis, Intestinal Barrier Injury, and Translational Opportunities Across the Childhood-A Narrative Review.Children (Basel, Switzerland) · 2026Review
- Gastrointestinal injury in cardiopulmonary bypass: current insights and future directions.Frontiers in pharmacology · 2025Review
- Increased Drop in Activity of Alkaline Phosphatase in Plasma from Patients with Endocarditis.International journal of molecular sciences · 2023Article
- Serum metabolic profile of postoperative acute kidney injury following infant cardiac surgery with cardiopulmonary bypass.Pediatric nephrology (Berlin, Germany) · 2021Article
- Diagnosis of Cardiac Surgery-Associated Acute Kidney Injury.Journal of clinical medicine · 2021Review
- Impact of Venoarterial Extracorporeal Membrane Oxygenation on Alkaline Phosphatase Metabolism after Cardiac Surgery.Biomolecules · 2021Article
- Impact of Subclinical Congestion on Outcome of Patients Undergoing Mitral Valve Surgery.Biomedicines · 2020Article
- Alterations in Metabolites Associated with Hypoxemia in Neonates and Infants with Congenital Heart Disease.Congenital heart disease · 2020Article
- Immediate Post-operative Enterocyte Injury, as Determined by Increased Circulating Intestinal Fatty Acid Binding Protein, Is Associated With Subsequent Development of Necrotizing Enterocolitis After Infant Cardiothoracic Surgery.Frontiers in pediatrics · 2020Article
- Tissue alkaline phosphatase activity and expression in an experimental infant swine model of cardiopulmonary bypass with deep hypothermic circulatory arrest.Journal of inflammation (London, England) · 2020Article
- Alkaline Phosphatase Treatment of Acute Kidney Injury in an Infant Piglet Model of Cardiopulmonary Bypass with Deep Hypothermic Circulatory Arrest.Scientific reports · 2019Article
- Metabolomic Fingerprinting of Infants Undergoing Cardiopulmonary Bypass: Changes in Metabolic Pathways and Association With Mortality and Cardiac Intensive Care Unit Length of Stay.Journal of the American Heart Association · 2018Article
- Infant cardiopulmonary bypass: CD73 kinetics, association with clinical outcomes, and influence on serum adenosine production capacity.Pediatric research · 2018Article
- Clinical features of low serum alkaline phosphatase levels in children: A retrospective study.Pediatrics international : official journal of the Japan Pediatric SocietyArticle
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9 authors at 4 institutions in 1 country.
Funding
Abstract
objectivesTo determine the kinetics of alkaline phosphatase (AP) activity and concentration after infant cardiopulmonary bypass, including isoform-specific changes, and to measure the association between postoperative AP activity and major postoperative cardiovascular events, organ injury/dysfunction, and postoperative support requirements STUDY
designProspective cohort study of 120 infants ≤120 days of age undergoing cardiopulmonary bypass. AP total and isoform-specific activity was assessed at 6 time points (preoperation, rewarming, 6, 24, 48, and 72 hours postoperation). Low AP activity was defined as ≤80 U/L. AP concentrations and biomarkers of organ injury/dysfunction were collected through 24 hours postoperation. Major cardiovascular events were defined as cardiac arrest, mechanical circulatory support, or death.
resultsAP activity loss occurred primarily during the operation (median decrease 89 U/L; P < .0001) secondary to decreased bone and liver 2 isoforms. Activity declined through 24 hours in 27% of patients. AP activity strongly correlated with serum concentration (r = 0.87-0.91; P < .0001). Persistent low AP activity at 72 hours was associated independently with occurrence of a major cardiac event (OR 5.6; P < .05). Early AP activity was associated independently with subsequent vasoactive-inotropic score (P < .001), peak lactate (P < .0001), peak creatinine (P < .0005), N-terminal pro-brain natriuretic peptide (P < .05), and intestinal fatty acid binding protein (P < .005).
conclusionsAP activity decreases during infant cardiopulmonary bypass and may continue to decrease for 24 hours. Activity loss is secondary to decreased bone and liver 2 isoform concentrations. Early low AP activity is associated independently with subsequent postoperative support and organ injury/dysfunction, and persistence of AP activity ≤80 U/L at 72 hours is associated independently with increased odds of major cardiovascular events.
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