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Perioperative infections in congenital heart disease
Indah K Murni1, Graeme MacLaren2, Debra Morrow3
11Department of Pediatrics,Dr Sardjito Hospital, Faculty of Medicine Universitas Gadjah Mada,Yogyakarta,Indonesia.
Insights
Perioperative infections significantly impact children with congenital heart disease (CHD), leading to severe health issues. More research is needed on effective interventions to reduce infection burden and improve surgical outcomes for these vulnerable patients.
Area of Science:
- Pediatric Cardiology
- Infectious Diseases
- Public Health
Background:
- Perioperative infections pose serious risks for children with congenital heart disease (CHD).
- These infections can lead to poor growth, cardiac failure, delayed surgeries, and increased mortality.
- Children with CHD have inherent risk factors like delayed presentation and poor nutrition.
Purpose of the Study:
- To systematically search and evaluate studies on the burden of perioperative infections in children with CHD.
- To identify existing interventions aimed at reducing these infections.
- To highlight gaps in research regarding infection prevention and management.
Main Methods:
- A systematic literature search was conducted using PubMed.
- Studies focusing on the burden and interventions for perioperative infections in pediatric CHD patients were included.
Main Results:
- Limited studies exist, particularly from low- to middle-income countries, indicating a substantial burden of perioperative infections.
- Most research focuses on postoperative infections, with few studies addressing preoperative infection prevention or its impact on surgical timing.
- Children with CHD present multiple infection risk factors.
Conclusions:
- The burden of perioperative infections in children with CHD is high, yet research on effective interventions is scarce.
- Strategies like optimizing nutrition, ensuring early corrective surgery, and minimizing nosocomial infections are crucial.
- Practical measures can be implemented to enhance surgical safety for pediatric CHD patients.
Background:
Perioperative infections have significant consequences for children with congenital heart disease (CHD), which can manifest as acute or chronic infection followed by poor growth and progressive cardiac failure. The consequences include delayed or higher-risk surgery, and increased postoperative morbidity and mortality.
Methods:
A systematic search for studies evaluating the burden and interventions to reduce perioperative infections in children with CHD was undertaken using PubMed.
Results:
Limited studies conducted in low- to middle-income countries demonstrated the large burden of perioperative infections among children with CHD. Most studies focussed on infections after surgery. Few studies evaluated strategies to prevent preoperative infection or the impact of infection on decision-making around the timing of surgery. Children with CHD have multiple risk factors for infections including delayed presentation, inadequate treatment of cardiac failure, and poor nutrition.
Conclusions:
The burden of perioperative infections is high among children with CHD, and studies evaluating the effectiveness of interventions to reduce these infections are lacking. As good nutrition, early corrective surgery, and measures to reduce nosocomial infection are likely to play a role, practical steps can be taken to make surgery safer.
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