Malnourished children undergoing cardiac surgery prone to ... - MIMS

Low preoperative serum protein and albumin levels are associated with an increased risk of surgical site infection (SSI) in paediatric patients undergoing cardiac surgery, reports a study. Malnutrition causes low serum protein and albumin levels.

A total of 765 consecutive paediatric cardiac surgeries were identified, of which 597 met the eligibility criteria for the final analysis. Of the included patients, 17 (2.8 percent) developed SSI (three superficial incisional SSI, two deep incisional SSI, and 12 mediastinitis cases). The major pathogen found was Staphylococcus aureus.

In univariate analysis, low preoperative serum protein (p=0.049) and low serum albumin levels (p=0.023) correlated with a higher risk of SSI development. None of the findings indicated impaired hepatic synthesis, inflammatory disease, or protein loss from the kidney or intestinal tract.

Of note, malnutrition was the main driver of low serum protein and albumin levels.

"Nutritional status should be regularly assessed in children scheduled for cardiac surgery, and interventions, such as nutritional guidance, should be considered if malnutrition is suspected," the researchers said.

A retrospective analysis was performed in patients aged <7 years who underwent surgery through a median sternotomy at Kagoshima University Hospital from April 2011 to March 2021. SSI was diagnosed based on the Centers for Disease Control and Prevention guidelines and categorized into the following: superficial incisional SSI, deep incisional SSI, and mediastinitis.

"SSI is a major complication of paediatric cardiac surgery," the researchers said. "If the risk of developing SSI can be predicted based on the patient's preoperative background, appropriate preoperative management to prevent the development of SSI can be achieved."

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