A team at Imperial College London has identified that babies and toddlers with congenital heart disease are at an increased risk of having harmful toxins in their blood, particularly following surgery.
Research found that children with high levels of toxins from gut bacteria in their blood are likely to take longer to recover from surgery and spend more time in intensive care. The research team says that more work needs to be done to protect these children from the bacterial toxin risks during heart surgery, perhaps using drugs that neutralise them or treatments that protect the gut. Dr Nazima Pathan, the lead author of the study from the National Heart and Lung Institute at Imperial College London, said: “The gut usually acts as a barrier that protects the body from toxins. However, our study suggests that in some babies with congenital heart disease, the gut isn’t able to do this job properly. These babies are often small and undernourished, and the heart defect can mean that the blood supply to the gut is abnormal. On top of this they have to cope with the trauma of surgery and our study suggests that all these factors can affect the protective barrier function of the gut.” Over a fifth of children from the survey had higher than normal levels of endotoxin, and levels rose after surgery. Overall, 27.5% of the children had raised endotoxin levels after surgery. The highest endotoxin levels were measured in small children and those whose heart defects resulted in compromised blood supply to the gut. Importantly, children with high endotoxin levels showed more signs of organ dysfunction and tended to spend longer in intensive care. The children may have been exposed to bacterial toxins during surgery. However, the levels of toxins in the blood continued to rise in the days after surgery, suggesting that bacteria in the gut were the main source.
