Systemic Inflammatory Response Syndrome in Pediatric Patients Undergoing Cardiac Surgery

Karacaer, Feride; Biricik, Ebru

doi:10.14744/GKDAD.2023.10438

Systemic Inflammatory Response Syndrome in Pediatric Patients Undergoing Cardiac Surgery

Feride KARACAER, (Çukurova Üniversitesi, Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Adana, TÜRKİYE)

Ebru BİRİCİK (Çukurova Üniversitesi, Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Adana, TÜRKİYE)

Göğüs Kalp Damar Anestezi ve Yoğun Bakım Derneği Dergisi

5 0

Yıl: 2023 Cilt: 29 Sayı: 2 Sayfa Aralığı: 95 - 101 Metin Dili: İngilizce DOI: 10.14744/GKDAD.2023.10438 İndeks Tarihi: 04-07-2023

Systemic Inflammatory Response Syndrome in Pediatric Patients Undergoing Cardiac Surgery

Öz:

Objectives: Cardiac surgery with cardiopulmonary bypass is a primary activator of the systemic inflammatory response syndrome (SIRS). To assess the association of SIRS with intraoperative variables and early postoperative outcomes, we compared SIRS incidence after cardiac surgery between cyanotic and acyanotic children. Methods: Using binary logistic regression models, we evaluated the incidence of SIRS between cyanotic and acyanotic children and the effect of intraoperative variables on SIRS occurrence and the effects of SIRS on postoperative complications. Results: A total of 175 children (69 cyanotic, 106 acyanotic) were included. Based on Mantel–Haenszel–Cochran analysis, considering the Risk Adjusted Classification for Congenital Heart Surgery score, the SIRS rate was higher at operation end in cyanotic children (p<0.001; 95% confidence interval: 1.94–10.61). An association was detected between SIRS incidence and consumption of red blood cells intraoperatively and fresh frozen plasma postoperatively. Lactate levels were higher in cyanotic than in acyanotic children at the end of the operation and at the postoperative 6th and 24th hours (p=0.008, 0.007, and 0.016, respectively). Lactate levels were higher in cyanotic children diagnosed with SIRS than in acyanotic children without SIRS at the end of the operation and the 6th postoperative hour (p=0.024 and 0.011, respectively). Vasoactive inotropic scores were higher in children with SIRS in the 6th and 24th postoperative hours (p=0.018 and 0.029, respectively). Conclusion: The incidence of SIRS is higher in children with complex cyanotic heart disease. Perioperative consumption of blood products in- creases SIRS occurrence.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Laffey JG, Boylan JF, Cheng DC. The systemic inflammatory re sponse to cardiac surgery: Implications for the anesthesiologist. Anesthesiology 2002;97:215–52.
2. Durandy Y. Minimizing systemic inflammation during cardio pulmonary bypass in the pediatric population. Artif Organs 2014;38:11–8.
3. Fudulu D, Angelini G. Oxidative stress after surgery on the imma ture heart. Oxid Med Cell Longev 2016;2016:1971452.
4. Manso PH, Carmona F, Dal-Pizzol F, Petronilho F, Cardoso F, Castro M, et al. Oxidative stress markers are not associated with outcomes after pediatric heart surgery. Paediatr Anaesth 2013;23:188–94.
5. Chew MS, Brandslund I, Brix-Christensen V, Ravn HB, Hjortdal VE, Pedersen J, et al. Tissue injury and the inflammatory response to pediatric cardiac surgery with cardiopulmonary bypass: A de scriptive study. Anesthesiology 2001;94:745–53.
6. Gaies MG, Gurney JG, Yen AH, Napoli ML, Gajarski RJ, Ohye RG, et al. Vasoactive-inotropic score as a predictor of morbidity and mortality in infants after cardiopulmonary bypass. Pediatr Crit Care Med 2010;11:234–8.
7. Jenkins KJ, Gauvreau K, Newburger JW, Spray TL, Moller JH, Iezzoni LI. Consensus-based method for risk adjustment for surgery for congenital heart disease. J Thorac Cardiovasc Surg 2002;123:110–8.
8. Goldstein B, Giroir B, Randolph A; International Consensus Con ference on Pediatric Sepsis. International pediatric sepsis consen sus conference: Definitions for sepsis and organ dysfunction in pediatrics. Pediatr Crit Care Med 2005;6:2–8.
9. Güvener M, Korun O, Demirtürk OS. Risk factors for systemic in flammatory response after congenital cardiac surgery. J Card Surg 2015;30:92–6.
10. Boehne M, Sasse M, Karch A, Dziuba F, Horke A, Kaussen T, Miko lajczyk R, et al. Systemic inflammatory response syndrome after pediatric congenital heart surgery: Incidence, risk factors, and clinical outcome. J Card Surg 2017;32:116–25.
11. Allan CK, Newburger JW, McGrath E, Elder J, Psoinos C, Laussen PC, et al. The relationship between inflammatory activation and clinical outcome after infant cardiopulmonary bypass. Anesth Analg 2010;111:1244–51.
12. de Fontnouvelle CA, Greenberg JH, Thiessen-Philbrook HR, Zap pitelli M, Roth J, Kerr KF, et al. Interleukin-8 and tumor necrosis factor predict acute kidney injury after pediatric cardiac surgery. Ann Thorac Surg 2017;104:2072–9.
13. Calza G, Lerzo F, Perfumo F, Borini I, Panizzon G, Moretti R, et al. Clinical evaluation of oxidative stress and myocardial reperfu sion injury in pediatric cardiac surgery. J Cardiovasc Surg (Torino) 2002;43:441–7.
14. Sharma R, Bolger AP, Li W, Davlouros PA, Volk HD, Poole-Wilson PA, et al. Elevated circulating levels of inflammatory cytokines and bacterial endotoxin in adults with congenital heart disease. Am J Cardiol 2003;92:188–93.
15. Nassef YE, Hamed MA, Aly HF. Inflammatory cytokines, apoptotic, tissue injury and remodeling biomarkers in children with con genital heart disease. Indian J Clin Biochem 2014;29:145–9.
16. Ranucci M, Baryshnikova E, Castelvecchio S, Pelissero G; Surgical and Clinical Outcome Research (SCORE) Group. Major bleeding, transfusions, and anemia: The deadly triad of cardiac surgery. Ann Thorac Surg 2013;96:478–85.
17. Willems A, Patte P, De Groote F, Van der Linden P. Cyanotic heart disease is an independent predicting factor for fresh frozen plas ma and platelet transfusion after cardiac surgery. Transfus Apher Sci 2019;58:304–9.
18. Zabala LM, Guzzetta NA. Cyanotic congenital heart disease (CCHD): Focus on hypoxemia, secondary erythrocytosis, and co agulation alterations. Paediatr Anaesth 2015;25:981–9.
19. Vlaar AP, Hofstra JJ, Determann RM, Veelo DP, Paulus F, Levi M, et al. Transfusion-related acute lung injury in cardiac surgery pa tients is characterized by pulmonary inflammation and coagu lopathy: A prospective nested case-control study. Crit Care Med 2012;40:2813–20.
20. Stephens EH, Epting CL, Backer CL, Wald EL. Hyperlactatemia: An update on postoperative lactate. World J Pediatr Congenit Heart Surg 2020;11:316–24.
21. Giacinto O, Satriano U, Nenna A, Spadaccio C, Lusini M, Mastroi anni C, et al. Inflammatory response and endothelial dysfunction following cardiopulmonary bypass: Pathophysiology and phar macological targets. Recent Pat Inflamm Allergy Drug Discov 2019;13:158–73.
22. Anttila V, Hagino I, Zurakowski D, Lidov HG, Jonas RA. Higher bypass temperature correlates with increased white cell activa tion in the cerebral microcirculation. J Thorac Cardiovasc Surg 2004;127:1781–8.
23. Schmitt KR, Fedarava K, Justus G, Redlin M, Böttcher W, Delmo Walter EM, et al. Hypothermia during cardiopulmonary bypass increases need for inotropic support but does not impact inflam mation in children undergoing surgical ventricular septal defect closure. Artif Organs 2016;40:470–9.

APA	Karacaer F, Biricik E (2023). Systemic Inflammatory Response Syndrome in Pediatric Patients Undergoing Cardiac Surgery. , 95 - 101. 10.14744/GKDAD.2023.10438
Chicago	Karacaer Feride,Biricik Ebru Systemic Inflammatory Response Syndrome in Pediatric Patients Undergoing Cardiac Surgery. (2023): 95 - 101. 10.14744/GKDAD.2023.10438
MLA	Karacaer Feride,Biricik Ebru Systemic Inflammatory Response Syndrome in Pediatric Patients Undergoing Cardiac Surgery. , 2023, ss.95 - 101. 10.14744/GKDAD.2023.10438
AMA	Karacaer F,Biricik E Systemic Inflammatory Response Syndrome in Pediatric Patients Undergoing Cardiac Surgery. . 2023; 95 - 101. 10.14744/GKDAD.2023.10438
Vancouver	Karacaer F,Biricik E Systemic Inflammatory Response Syndrome in Pediatric Patients Undergoing Cardiac Surgery. . 2023; 95 - 101. 10.14744/GKDAD.2023.10438
IEEE	Karacaer F,Biricik E "Systemic Inflammatory Response Syndrome in Pediatric Patients Undergoing Cardiac Surgery." , ss.95 - 101, 2023. 10.14744/GKDAD.2023.10438
ISNAD	Karacaer, Feride - Biricik, Ebru. "Systemic Inflammatory Response Syndrome in Pediatric Patients Undergoing Cardiac Surgery". (2023), 95-101. https://doi.org/10.14744/GKDAD.2023.10438

APA	Karacaer F, Biricik E (2023). Systemic Inflammatory Response Syndrome in Pediatric Patients Undergoing Cardiac Surgery. Göğüs Kalp Damar Anestezi ve Yoğun Bakım Derneği Dergisi, 29(2), 95 - 101. 10.14744/GKDAD.2023.10438
Chicago	Karacaer Feride,Biricik Ebru Systemic Inflammatory Response Syndrome in Pediatric Patients Undergoing Cardiac Surgery. Göğüs Kalp Damar Anestezi ve Yoğun Bakım Derneği Dergisi 29, no.2 (2023): 95 - 101. 10.14744/GKDAD.2023.10438
MLA	Karacaer Feride,Biricik Ebru Systemic Inflammatory Response Syndrome in Pediatric Patients Undergoing Cardiac Surgery. Göğüs Kalp Damar Anestezi ve Yoğun Bakım Derneği Dergisi, vol.29, no.2, 2023, ss.95 - 101. 10.14744/GKDAD.2023.10438
AMA	Karacaer F,Biricik E Systemic Inflammatory Response Syndrome in Pediatric Patients Undergoing Cardiac Surgery. Göğüs Kalp Damar Anestezi ve Yoğun Bakım Derneği Dergisi. 2023; 29(2): 95 - 101. 10.14744/GKDAD.2023.10438
Vancouver	Karacaer F,Biricik E Systemic Inflammatory Response Syndrome in Pediatric Patients Undergoing Cardiac Surgery. Göğüs Kalp Damar Anestezi ve Yoğun Bakım Derneği Dergisi. 2023; 29(2): 95 - 101. 10.14744/GKDAD.2023.10438
IEEE	Karacaer F,Biricik E "Systemic Inflammatory Response Syndrome in Pediatric Patients Undergoing Cardiac Surgery." Göğüs Kalp Damar Anestezi ve Yoğun Bakım Derneği Dergisi, 29, ss.95 - 101, 2023. 10.14744/GKDAD.2023.10438
ISNAD	Karacaer, Feride - Biricik, Ebru. "Systemic Inflammatory Response Syndrome in Pediatric Patients Undergoing Cardiac Surgery". Göğüs Kalp Damar Anestezi ve Yoğun Bakım Derneği Dergisi 29/2 (2023), 95-101. https://doi.org/10.14744/GKDAD.2023.10438