الفهرس 
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Abstract
Background: The inflammatory response due to cardiopulmonary bypass (CBP) activates different inflammatory pathways which affect multiple organs. Dexmedetomidine is proved to affect inflammatory marker production. Objectives: Evaluation of the effect of Dexmedetomidine on the inflammatory response associated with pediatric open-heart surgery using interleukin-6 (IL-6) and interferon gamma (INF-ɤ) levels. Methods: 46children aged between one to eight years undergoing elective repair of non-cyanotic congenital heart disease with CPB were randomly assigned into two groups. The control group (19 patients) received normal saline, whereas the Dex group (27 patients) received an initial bolus of Dexmedetomidine 0.5 µg/kg followed immediately by infusion of 0.5 µg/kg/hr continued till the end of CPB. The level of IL-6 and INF-ɤ was measured. Hemodynamic, ICU and hospital data were recorded.Results: IL-6 and INF -ɤ levels were increased significantly with time in control group, with no increase in their levels in the Dex group. They were significantly lower in the Dex group compared to the control group in samples taken during bypass, 6 hours and 24 hours after the operation (the end of surgical procedure). There was significant difference between the groups regarding inotropic score and mechanical ventilation. There was no significant difference between the groups regarding complications, duration of ICU or hospital stay. Limitations This study had some limitations. First, we used IL-6 and INF-ɤ as biomarkers for inflammatory response to surgery and CPB, however additional inflammatory markers should have been investigated. Secondly, the study was performed in non-cyanotic congenital cardiac surgery which has less inflammatory response. Finally, a wide range of age was investigated with possible effects on the results. RecommendationsA larger size and multicenter clinical trial is warranted to investigate additional inflammatory biomarkers in response to surgery and CPB as we utilized only IL-6 and INF-ɤ. Moreover, future studies are recommended to focus on different infusion doses of dexmedetomidine in Pediatrics to reach the optimum dose with the best possible hemodynamics, to study the effect of dexmedetomidine after bypass - especially in patients that are extubated on it in the OR. Conclusion from the findings of the present study we conclude that in pediatric cardiac surgery for non-cyanotic heart diseases; dexmedetomidine administration can decrease the inflammatory response to surgery and CBP. It was useful in decreasing the level of inflammatory mediators, inotropic support, and duration of mechanical ventilation, but not the length of either ICU or hospital stay Declaration of interest: None declared. Funding This research was funded by the Grant Office, Faculty of Medicine, Assiut University (under No. 2016/07/03-008). The laboratory tests were performed in the Medical Research Center, Faculty of Medicine, Assiut University.