Description

Mehta et al identified risk factors for infection following pediatric cardiac surgery with sternotomy. These can help to identify a patient who may benefit from more aggressive management. The authors are from State University of New York Upstate Medical University in Syracuse.


Patient selection: pediatric patient with median sternotomy for cardiac surgery

 

Sternal wound infection occurrence rate: 5%

 

Risk factors for sternal wound infection:

(1) younger age (mean 4.7 +/- 4.2 months vs 45.4 +/- 57.7 months without infection)

(2) higher ASA class (3 to 5)

(3) longer preoperative stay hospital (more than one week)

(4) longer period of mechanical ventilation

(5) longer period of inotropic support

(6) higher leukocyte band count preoperatively and on postoperative day 1

 

Patients who developed a sternal wound infection tended to have a longer postoperative ICU and hospital stay.

 

Other infections included:

(1) pneumonia

(2) bacteremia

(3) urinary tract infection

 

Risk for other infections increased with:

(1) longer bypass time

(2) longer operation time

(3) longer duration of inotropic support

(4) longer duration of mechanical ventilation


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