Systemic Inflammatory Response Syndrome in Pediatric Patients Undergoing Cardiac Surgery

Objectives: Cardiac surgery with cardiopulmonary bypass is a primary activator of the systemic inflammatory response syndrome (SIRS). To assess the association of SIRS with intraoperative variables and early postoperative outcomes, we compared SIRS incidence after cardiac surgery between cyanotic and acyanotic children.
Methods: Using binary logistic regression models, we evaluated the incidence of SIRS between cyanotic and acyanotic children and the effect of intraoperative variables on SIRS occurrence and the effects of SIRS on postoperative complications.
Results: A total of 175 children (69 cyanotic, 106 acyanotic) were included. Based on Mantel–Haenszel–Cochran analysis, considering the Risk Adjusted Classification for Congenital Heart Surgery score, the SIRS rate was higher at operation end in cyanotic children (p<0.001; 95% confidence interval: 1.94–10.61). An association was detected between SIRS incidence and consumption of red blood cells intraoperatively and fresh frozen plasma postoperatively. Lactate levels were higher in cyanotic than in acyanotic children at the end of the operation and at the postoperative 6th and 24th hours (p=0.008, 0.007, and 0.016, respectively). Lactate levels were higher in cyanotic children diagnosed with SIRS than in acyanotic children without SIRS at the end of the operation and the 6th postoperative hour (p=0.024 and 0.011, respectively). Vasoactive inotropic scores were higher in children with SIRS in the 6th and 24th postoperative hours (p=0.018 and 0.029, respectively).
Conclusion: The incidence of SIRS is higher in children with complex cyanotic heart disease. Perioperative consumption of blood products increases SIRS occurrence.