Alexis Chenouard1, Jean-Christophe Rozé, Matthieu Hanf, Julie Macher, Jean-Michel Liet, Véronique Gournay, Christèle Gras-Le Guen, Nicolas Joram. 1. 1Department of Pediatric Intensive Care, Nantes University Hospital, Nantes, France. 2Clinical Investigation Center, National Institute of Health and Medical Research, Nantes University Hospital, Nantes, France. 3Department of Pediatric Cardiology, Nantes University Hospital, Nantes, France. 4Department of Emergency Medicine, Nantes University Hospital, Nantes, France.
Abstract
OBJECTIVES: Recent data have suggested a link between plasma transfusion and the development of nosocomial infections in critically ill children. However, to our knowledge, no study has specifically focused on this association among children undergoing cardiac surgery. Thus, the main objective of this study was to analyze the relationship between plasma transfusion after cardiac surgery and the risk of nosocomial infections, including bloodstream infections, mediastinitis, and ventilator-associated pneumonia, in children younger than 1 year. DESIGN: Observational single-center study. SETTING: A 12-bed tertiary PICU in a university hospital in France. PATIENTS: Children less than 1 year admitted after cardiac surgery under cardiopulmonary bypass between November 2007 and December 2012. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Data from 233 children were analyzed, of which 94 children (40%) had been transfused with plasma during their PICU stay. Fifty-six episodes of nosocomial infections (51 children) were reported, yielding a nosocomial infection ratio of 24%. The unadjusted odds ratio for developing nosocomial infections associated with plasma transfusion was 4.1 (95% CI, 2.1-7.9; p < 0.001). After adjusting for a propensity score, there was no difference between the two groups (adjusted odds ratio, 1.5; 95% CI, 0.5-4.0; p = 0.5). CONCLUSION: Plasma transfusion following cardiac surgery under cardiopulmonary bypass was not independently associated with the development of nosocomial infections in children (< 1 yr old) after adjustment for a propensity score.
OBJECTIVES: Recent data have suggested a link between plasma transfusion and the development of nosocomial infections in critically ill children. However, to our knowledge, no study has specifically focused on this association among children undergoing cardiac surgery. Thus, the main objective of this study was to analyze the relationship between plasma transfusion after cardiac surgery and the risk of nosocomial infections, including bloodstream infections, mediastinitis, and ventilator-associated pneumonia, in children younger than 1 year. DESIGN: Observational single-center study. SETTING: A 12-bed tertiary PICU in a university hospital in France. PATIENTS: Children less than 1 year admitted after cardiac surgery under cardiopulmonary bypass between November 2007 and December 2012. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Data from 233 children were analyzed, of which 94 children (40%) had been transfused with plasma during their PICU stay. Fifty-six episodes of nosocomial infections (51 children) were reported, yielding a nosocomial infection ratio of 24%. The unadjusted odds ratio for developing nosocomial infections associated with plasma transfusion was 4.1 (95% CI, 2.1-7.9; p < 0.001). After adjusting for a propensity score, there was no difference between the two groups (adjusted odds ratio, 1.5; 95% CI, 0.5-4.0; p = 0.5). CONCLUSION: Plasma transfusion following cardiac surgery under cardiopulmonary bypass was not independently associated with the development of nosocomial infections in children (< 1 yr old) after adjustment for a propensity score.
Authors: Ryan Closson; Elizabeth Mauer; Arabela Stock; Jeffrey D Dayton; Damien J LaPar; Maria C Walline; Marianne E Nellis Journal: Crit Care Explor Date: 2020-08-05