1. Hypogammaglobulinemia after cardiopulmonary bypass in infants
- Author
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Leslie A. Rhodes, T. Prescott Atkinson, Stephen M. Robert, Jeffrey A. Alten, Robert J. Dabal, and Alla M. Mahdi
- Subjects
Heart Defects, Congenital ,Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Time Factors ,Secondary infection ,medicine.medical_treatment ,Immunoglobulins ,Article ,Peritoneal dialysis ,law.invention ,Capillary Permeability ,Hypogammaglobulinemia ,Agammaglobulinemia ,Risk Factors ,law ,Intensive Care Units, Neonatal ,medicine ,Cardiopulmonary bypass ,Humans ,Retrospective Studies ,Cross Infection ,Cardiopulmonary Bypass ,business.industry ,Incidence ,Infant, Newborn ,Acute Kidney Injury ,Length of Stay ,Water-Electrolyte Balance ,medicine.disease ,Respiration, Artificial ,Surgery ,Cardiac surgery ,Systemic inflammatory response syndrome ,Treatment Outcome ,surgical procedures, operative ,Anesthesia ,Alabama ,Coronary care unit ,Cytokines ,Female ,Fresh frozen plasma ,Inflammation Mediators ,Cardiology and Cardiovascular Medicine ,business ,Biomarkers ,circulatory and respiratory physiology - Abstract
BackgroundHypogammaglobulinemia has been reported after cardiac surgery and may be associated with adverse outcomes. We sought to define baseline immunoglobulin (Ig) concentration in neonates and infants with congenital heart disease, determine their course after cardiopulmonary bypass (CPB), and determine if post-CPB hypogammaglobulinemia was associated with increased morbidity.MethodsThis was a single-center, retrospective analysis of infants who underwent cardiac surgery with CPB between June 2010 and December 2011. The Ig concentration was obtained from banked plasma of 47 patients from a prior study (pre-CPB, immediately post-CPB, and 24 and 48 hours post-CPB). In addition, any Ig levels drawn for clinical purposes after CPB were included. Ig levels were excluded if drawn after chylothorax diagnosis or intravenous IgG administration.ResultsThe median age was 7 days. Preoperative Ig concentration was similar to that described in healthy children. IgG level decreased to less than 50% of preoperative concentration by 24-hour post-CPB and failed to recover by 7 days. Of 47 patients, 25 (53%) had low IgG (
- Published
- 2014