Correlation between neutrophil to lymphocyte ratio changes and prognosis in children with congenital heart disease after cardiopulmonary bypass

Chu Minjun; Ren Zhaoling; Gao Jian; Li Junxian; Wang Xiaocong; Kang Jinsuo; Chen Rong

doi:10.13498/j.cnki.chin.j.ecc.2024.04.06

Abstract：Objective To investigate the changes of neutrophil to lymphocyte ratio(NLR)and its relationship with prognosis in children with congenital heart disease(CHD)after cardiopulmonary bypass(CPB).Methods A total of 150 young children under 1 year old who underwent CPB surgery in our hospital due to CHD from January 2019 to December 2022 were selected for analysis,and were divided into CPB<120min group and CPB≥120min group according to CPB time.Baseline data,blood routine examination,and postoperative outcomes(including postoperative infections,mechanical ventilation time,ICU stay,and hospital stay)were collected and analyzed to evaluate the relationship between changes in NLR and prognosis of CPB.The Mann-Whitney U test was used to compare differences between groups.Repeated measures ANOVA was employed to compare perioperative NLR values among patients with different CPB.Results After CPB,NLR exhibited an initial increase followed by a decrease,with the peak occurring on postoperative day 1-2.There were no significant differences in NLR between the two CPB duration groups preoperatively,on the day of surgery,and 1 day after surgery(P>0.05).However,from postoperative day 2 onwards,patients with CPB≥120 min had significantly higher NLR values compared to those with CPB<120 min(all P<0.01).Patients who experienced postoperative infection,mechanical ventilation for≥72 hours,ICU stay for≥72 hours,and total hospitalization time for≥10 days had longer times to reach the NLR peak,and those with hospitalization≥10 days had significantly higher postoperative NLR peaks(P<0.01).Conclusion The duration of CPB surgery can impact the postoperative NLR recovery trend,with longer times to reach the NLR peak being associated with adverse prognosis.Delayed peak times of postoperative NLR should prompt timely measures to prevent postoperative infections and complications.