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[Fever and infection after heart surgery. A prospective study of 75 cases]
C L Andrade1, S Olvera, P A Reyes
1Instituto Nacional de Cardiologia Ignacio Chávez, México, D.F.
Abstract:
We prospectively studied 75 patients who underwent elective cardiac surgery, they were otherwise health and were not using inflammation modifying drugs. Their febrile response and inflammatory conditions after surgery were monitored. Most of them had fever, 52/75 (64%). Postoperative infection was rare (13%) and when present, it was due to pathogens easily treated. Contamination-/infection of genitourinary tract occurred in 10/24 cases (16%), only one case was symptomatic. There was no difference in febrile response between infected and not-infected patients, neither the "routine" laboratory evaluation allowed differentiation, therefore the diagnosis of postoperative infection remains clinical. There is difference in febrile response between patients who had or had not extracorporeal circulation during the surgical procedure. In the later, fever developed 2 days later and it had longer duration.
Insights
Postoperative fever after cardiac surgery is common, but infection is rare and difficult to diagnose with lab tests. Extracorporeal circulation impacts fever duration.
Area of Science:
- Cardiovascular Surgery
- Infectious Disease Epidemiology
Context:
- Prospective study of 75 healthy patients undergoing elective cardiac surgery.
- Exclusion of patients using inflammation-modifying drugs.
- Monitoring of febrile response and inflammatory conditions post-surgery.
Purpose:
- To investigate the incidence and characteristics of fever after cardiac surgery.
- To determine the correlation between fever, infection, and extracorporeal circulation.
- To evaluate the diagnostic utility of laboratory tests for postoperative infection.
Summary:
- Fever occurred in 64% of patients; postoperative infection was rare (13%) and generally treatable.
- Genitourinary tract contamination/infection occurred in 16% of relevant cases, mostly asymptomatic.
- No significant difference in fever between infected and non-infected patients; diagnosis remains clinical.
- Patients undergoing extracorporeal circulation experienced delayed and prolonged fever compared to those without.
Impact:
- Highlights the clinical nature of diagnosing postoperative infections in cardiac surgery patients.
- Suggests extracorporeal circulation as a factor influencing postoperative febrile response.
- Informs clinical practice regarding fever management and infection surveillance post-cardiac procedures.