1377 Duration of Cardiopulmonary Bypass in Pediatric Cardiac Surgery is Not Associated with Postoperative Infections

Abstract

Background and aims: In pediatric cardiac surgery, cardiopulmonary bypass (CPB) is frequently employed. CPB is known to initiate a systemic inflammatory response, although other factors like anesthesia, ischemia/ reperfusion and the surgical procedure itself may play a role. The systemic inflammation is composed of a pro- and anti-inflammatory phase, of which the latter can lead to postoperative infections. We hypothesised that longer duration of CPB in pediatric cardiac surgery is associated with increased occurrence of postoperative infections.Methods: All pediatric patients undergoing cardiac surgery with CPB from April 2006 until May 2009 were included in a retrospective analysis. Postoperative infections were categorised according to Centre of Disease Control-criteria. Logistic regression was used to discriminate whether duration of CPB was associated with postoperative infections, and whether this relationship was confounded by variables such as weight, surgical complexity and lowest intra-operative temperature.Results: In 364 patients, 412 procedures were performed (median age 29 weeks). An infection occurred following 25% of the procedures (median start on postoperative day 7). The most common were blood stream infections (25% of all infections) and surgical site infections (26%). In univariate analysis, duration of CPB was associated with the occurrence of postoperative infections. However, this association was disturbed when correcting for weight, surgical complexity and lowest intraoperative temperature in multivariable analysis.Conclusions: In pediatric cardiac surgery, longer duration of CPB in itself is not associated with postoperative infections. Therefore, other factors are likely to contribute to the high incidence of postoperative infections after pediatric cardiac surgery.