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1668 Systemic Inflammatory Response Syndrome (SIRS), Multiple Organ Dysfunction Syndrome (MODS) and Sepsis after Open Heart Surgery in Children
  1. T da Rocha1,
  2. A Botta2,
  3. LD Mulle2,
  4. C Ricachinevsky2,
  5. P Carvalho1
  1. 1Uti Pediatrica Hospital Santo Antonio, Universidade Federal do Rio Grande do Sul
  2. 2Uti Pediatrica Hospital Santo Antonio, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil

Abstract

Background and Aim Circulatory bypass (CBP) causes SIRS and MODS and the study of this prevalence is rare.

Methods We retrospectively made a cohort of 121 children operated during August, 2008 to July, 2009 to study the prevalence of SIRS, MODS and sepsis after open heart surgery.

Results The median age, weigtht, CBP time and temperature during CBP were 9 months, 6 Kg, 55 minutes and 32 º C, respectively. We found 48% of septal defects. During the first hour in PCIU 50.4 (%) had the SIRS criteria with hypothermia present in 96.7(%). Hypothermia was most frequent during all postoperative days except the second when hyperthermia was present in 41.6 (%) vs 29.1(%) of hypothermia. The others SIRS criteria such as elevated respiratory rate, heart rate and leucocytosis were present in 81.3 to 91.7(%), 25 to 37.5 (%) and 25 to 76.5(%) of children, respectively. MODS criteria were present in 22.3 (%) at arrive in PICU. During next postoperative days, MODS was more frequent than SIRS as follows: in the first day 53.8 (%) vs 32.2 (%), second 41.3 (%) vs 39.7 (%), third 29.8 (%) vs 19.8 (%), forth 24.8(%) vs 17.4 (%) and fifth 24.8(%) vs 13.2 (%). After the third, forth and fifth postoperative days 56.2 (%), 62(%) and 69.4 (%) of children, respectively, did not have SIRS or MODS. Prevalence of sepsis was 27.7 (%).

Conclusion After open heart surgery in children, SIRS and MODS are more frequent in first 48 hours than other diagnosis.

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