J.Jpn. Surg. Soc.. 83(10): 1190-1198, 1982

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Original article

INFECTION AFTER CARDIAC SURGERY
－CLINICAL STUDY ON THE BASIS OF THE IMMUNE HOST DEFENSE MECHANISM AND THE NUTRITIONAL STATUS－

Three hundred eighty one patients who underwent open heart surgery with cardiopulmonary bypass were studied on the postoperative bacterial infection, post-transfusion hepatitis, and febrile response due to unknown etiology. The following variables were used in order to evaluate the preoperative nutritional status and immune host defense mechanism and in order to compare the incidence of infection with them ; 1) New York Heart Association functional classification, 2) Body weight/height ratio, 3) Serum protein, albumin, A/G ratio, 4) Serum concentration of immunoglobulins (IgG, IgM, IgA), and complement fractions (C₃, C₄), 5) The amount of white cells, red cells, and lymphocytes, 6) Prognostic Nutritional Index (P.N.I.). The relation between the incidence of infection and the effects of cardiopulmonary bypass on the immune host defense mechanism was also studied.
Bacterial infection occured in 49 cases (12.6%), post-transfusion hepatitis in 67 cases (17.6%), and febrile response in 109 cases (28.6%). Gram negative bacilli accounted for about 74 % of isolates. Glucose non-fermentative gram-negative bacilli without Pseudomonas aeruginosa accounted for 26.2% of isolates. Staphylococcus epidermidis was isolated in 7 cases (10.8% of isolates). These organisms are considered to be opportunistic pathogens.

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