Postoperative prevalence of the persistent inflammation, immunosuppression and catabolism syndrome in pediatric patients (PICS-ped) in a pediatric tertiary hospital: a cross-sectional study

• Grant number: 21/08819-5
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: January 01, 2022
• End date: December 31, 2022
• Field of knowledge: Health Sciences - Medicine - Maternal and Child Health
• Principal Investigator: Fabio Carmona
• Grantee: João Vitor Casimiro Mendes de Oliveira
• Host Institution: Faculdade de Medicina de Ribeirão Preto (FMRP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil

Abstract

Patients submitted to elective surgeries can have complicated postoperative courses and persistent inflammation, immunosuppression, and catabolism syndrome (PICS). This leads to poor outcomes and death, as a consequence of catabolism and immunosuppression. Children can equally have the pediatric PICS (PIS-ped), but in this population, the syndrome is not well defined regarding its incidence and the distinct profiles of catabolism and immunosuppression. This study aims to describe the prevalence of PICS-ped after pediatric surgery, and whether it is associated to distinct profiles of immune response (Th1, Th2, Th9, Th17, or Treg). For this, we propose a cross-sectional, observational study at HC Criança, Hospital das Clinicas at Ribeirão Preto Medical School, University of Sao Paulo. We aim to include 40 to 80 children 19 years with PICS-ped. Clinical data will be recorded, and a blood sample will be drawn to determine the levels of interleukins in plasma (IL-1², IL-6, IL-8, IL-12, IL-23, TNF, IFN-³, IL-17, IL-4, IL-9, IL-10 e TGF-²) and to separate leukocytes for phenotype by flow cytometry, and to assess lymphoproliferative response after stimuli with anti-CD3 and anti-CD28 monoclonal antibodies for 5 days. We expect to identify at least 5 patients with PICS-ped and we believe their lymphoproliferative capacity is reduced. The characterization of their distinct immune profile can bring new insights to prevent this condition.(AU)