The Immunologic System: Perturbations Following Cardiopulmonary Bypass and the Problem of Infection in the Cardiac Surgery Patient

  • Bradley L. Bufkin
  • John Parker Gott
  • Christina T. Mora
  • Jerrold H. Levy

Abstract

Cardiopulmonary bypass (CPB) predisposes cardiac surgical patients to postoperative wound infections1,2 by altering their immunologic host response and increasing their susceptibility to infection, a primary cause of morbidity and mortality following open-heart surgery. The “cost” of infection after cardiac surgery includes human suffering, hospital confinement, loss of productivity, and mortality. There can be a broad range of infectious complications postoperatively (Table 8.1). Mediastinitis, occurring in 1% to 2% of median sternotomies, has a mortality rate of 60% to 70%.3 Early and late prosthetic valvular endocarditis are associated with mortality rates of 73% and 45%, respectively,4,5 and occur in approximately 2% to 3% of valvular replacement procedures. An assessment of hospital stay following coronary artery bypass surgery demonstrated that infectious complications prolonged hospitalization fourfold, with infection representing the most important variable for increased length of stay.6 A 1990 cost assessment of cardiac surgery patients reported that median sternotomy infections produced a median hospital cost of $58,092 (range $19,966 to $408,632), almost triple the cost of an uncomplicated cardiac procedure.7

Keywords

Obesity Catheter Depression Heparin Sedimentation 

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Copyright information

© Springer-Verlag New York Inc. 1995

Authors and Affiliations

  • Bradley L. Bufkin
  • John Parker Gott
  • Christina T. Mora
  • Jerrold H. Levy

There are no affiliations available

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