Cardiac surgery and sepsis in postoperative period - our experience

The occurrence of sepsis after cardiac surgery is a rare event; however, its occurrence showed catastrophic clinical outcomes. The high morbidity and mortality revealed the need to improve treatment, aiming at patients' better clinical outcome. Patients that develop sepsis, regardless of the infectious focus and the subjacent disease, present high morbidity and mortality, which vary from 17% to 65%. The main predictors of infections in the postoperative period are: body mass index >= 40kg/ m(2), haemodialysis in the preoperative period, pre-op cardiogenic shock, age >= 80 years, pre-op treatment with immunosuppressive agents, diabetes mellitus, ECC time >= 200 minutes, mechanical circulatory support, three or more revascularized vessels. From January 2015 to December 2015, we studied 675 adult patients who underwent cardiac surgery. Prophylactic antibiotic therapy was prescribed and given according to our protocol, from the induction of anaesthesia to the first postoperative day. Sepsis in the postoperative period was defined as evidence on infection associated with two or more criteria of systemic inflammatory response syndrome: body temperature > 38 degrees C or < 36 degrees C, leukocytes > 12,000 cells/mm(3), positive blood cultures, respiratory rate > 20/min, heart rate > 100/min.