Kinetics of C-reactive protein in children with congenital heart diseases in the early period after cardiosurgical treatment with extracorporeal circulation.

PURPOSE

The aim of the study was to assess postoperative C-reactive protein (CRP) serum kinetics in children without clinical signs of infection after atrial and ventricular septal defects closure in terms of extracorporeal circulation (ECC).

MATERIAL/METHODS: Fifty-two patients met inclusion criteria and were divided into 2 groups: group A (antibiotic prophylaxis with cefazolin given up to 48 h postoperatively) and group B (antibiotic prophylaxis with amoxicillin and clavunic acid given more than 48 h postoperatively). The CRP was measured perioperatively in both groups. The CRP evaluation was the part of routine lab-tests during perioperative period, without any modification of the typical perioperative strategy. In the postoperative period CRP was measured after 24h, 48 h, 72 h and 96 h in both groups.

RESULTS

There were no differences between CRP levels between both groups of patients. The peak CRP values were observed after 48 h after the operation in ECC in both groups and decreased in the next postoperative days.

CONCLUSIONS

In children with congenital heart defects undergoing cardiosurgical treatment with the use of ECC the assessing CRP values in the first postoperative day remains questionable. The maximum peak CRP value after operation with ECC can be much higher than the reference values without infection complications. Single CRP assessment in early postoperative period in these groups of children can lead to over-diagnosis of infections and antibiotics abuse.