Clinical profile of systemic inflammatory response after pediatric cardiac surgery with cardiopulmonary bypass

• Published in: Arquivos brasileiros de cardiologia 2010-01, Vol.94 (1), p.127-133
• Main Authors: Soares, Leonardo Cavadas da Costa, Ribas, Denise, Spring, Regine, Silva, Jean Marcelo Ferreira da, Miyague, Nelson Itiro
• Format: Article
• Language: Portuguese
• Subjects: Brazil - epidemiology; Cardiac Surgical Procedures - adverse effects; Cardiac Surgical Procedures - methods; Cardiomyopathies - surgery; Cardiopulmonary Bypass; Female; Heart Defects, Congenital - surgery; Hemodynamics - physiology; Humans; Infant; Male; Multivariate Analysis; Risk Factors; Systemic Inflammatory Response Syndrome - epidemiology; Systemic Inflammatory Response Syndrome - etiology
• ISSN: 1678-4170
• DOI: 10.1590/S0066-782X2010000100019

the postoperative period of congenital cardiomyopathies correction is frequently accompanied by systemic inflammatory response. To assess the frequency of occurrence and clinical manifestations of the systemic inflammatory response syndrome after cardiopulmonary bypass (SIRS-CPB) in children submitted to cardiac surgery. Historical cohort study including patients up to 3 years old that were submitted to elective corrective surgeries for congenital cardiopathies with cardiopulmonary bypass (CPB). A total of 101 patients were assessed by means of clinical criteria of organ dysfunction through score tests, as comparing predisponent factors and aggregated morbidity to the presence of SIRS-CPB. Twenty-two patients (21.9%) fulfilled the criteria for SIRS-CPB. The sex or type of cardiopathy did not differ between groups (p = NS). Patients diagnosed with SIRS-CPB (compared to patients without SIRS-CPB) presented lower mean age (6.8 +/- 5.5 versus 10.8 +/- 5.1 months, p < 0.05), lower weight (5.3 +/- 1.9 versus 6.9 +/- 2.0 kg, p < 0.05), and longer CPB duration (125.1 +/- 49.5 versus 93.9 +/- 33.1 minutes, p < 0.05). Longer median duration of mechanical ventilation (120.0 versus 13.0 hours, p < 0.05), longer stay in Intensive Care Unit (ICU) (265.0 versus 107.0 hours, p < 0.05) and in hospital (22.0 versus 10.0 days, p < 0.05) were observed. In the multivariate analysis, higher weight (OR = 0.68, p = 0.01) was identified as a protection factor. The adopted clinical criteria identified a risk group for SIRS-CPB, which presented lower weight and longer CPB duration as predisponent factors. Patients with SIRS-CPB remain in mechanical ventilation, in ICU and in hospitalization for a longer period of time.