[Clinical profile of systemic inflammatory response after pediatric cardiac surgery with cardiopulmonary bypass].
BACKGROUND
the postoperative period of congenital cardiomyopathies correction is frequently accompanied by systemic inflammatory response.


OBJECTIVE
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Soares
Leonardo Cavadas da Costa
LC
Hospital Infantil Pequeno Príncipe, PR, Brasil. leo.cavadas@ yahoo.com.br
Ribas
Denise
D
Spring
Regine
R
Silva
Jean Marcelo Ferreira da
JM
Miyague
Nelson Itiro
NI
D001938:Brazil / Q000453:epidemiology; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D009202:Cardiomyopathies / Q000601:surgery*; D002315:Cardiopulmonary Bypass; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007223:Infant; D008297:Male; D015999:Multivariate Analysis; D012307:Risk Factors; D018746:Systemic Inflammatory Response Syndrome / Q000453:epidemiology* / Q000209:etiology