title: Postoperative fever and major infections after pediatric cardiac surgery.
abstract: OBJECTIVE
  1) to identify the current status of major infections and other etiologies of postoperative fever from pediatric cardiac surgery 2) to determine the risk factors of major infections.
  
  
  METHODS
  Databases of pediatric cardiac surgery patients in 2005 were retrospectively reviewed. The main outcomes of interest were postoperative fever and its etiologies. Potential predictors were analyzed by comparing patients who developed or did not have infections.
  
  
  RESULTS
  Two hundred thirty patients, 43% (n = 99) developed postoperative fever. Major infections occurred in 13.5% (n = 31), and postpericardiotomy syndrome (PPS) was seen in 8.7% (n = 20) of the patients. The infection rate was 16.9/100 procedures, including pneumonia (29 episodes) and bloodstream infection (6 episodes). Risk factors were infancy, prolonged ventilator support > 2 days, hospital length of stay (LOS) > 14 days, intensive care unit (ICU) LOS > 3 days, re-open procedure, and extubation failure rate. Conversely, cyanosis and high complexity operations were not associated. Positive erythrocyte sedimentation rate was related to infections or to PPS (the area under the ROC = 0.72).
  
  
  CONCLUSIONS
  Following pediatric cardiac surgery major infections are still problematic. The risks increase with infancy, prolonged ventilator support, prolonged hospital and ICU LOS, re-open procedure, and extubation failure.
authors: Division of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Bangkok, Thailand. cvijarnsorn@yahoo.com
authors: Chodchanok
authors: C
authors: Vijarnsorn
authors: Gornmiga
authors: G
authors: Winijkul
authors: Duangmanee
authors: D
authors: Laohaprasitiporn
authors: Paweena
authors: P
authors: Chungsomprasong
authors: Prakul
authors: P
authors: Chanthong
authors: Kritvikrom
authors: K
authors: Durongpisitkul
authors: Jarupim
authors: J
authors: Soonswang
authors: Apichart
authors: A
authors: Nana
authors: Thaworn
authors: T
authors: Subtaweesin
authors: Somchai
authors: S
authors: Sriyoschati
authors: Julaporn
authors: J
authors: Pooliam
mesh_terms: D000293:Adolescent; D060666:Airway Extubation; D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology; D013504:Cardiovascular Surgical Procedures; D002648:Child; D002675:Child, Preschool; D005260:Female; D005334:Fever / Q000453:epidemiology*; D006330:Heart Defects, Congenital / Q000453:epidemiology / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D008297:Male; D011014:Pneumonia / Q000453:epidemiology* / Q000382:microbiology; D011183:Postoperative Complications / Q000453:epidemiology*; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012307:Risk Factors; D013785:Thailand / Q000453:epidemiology