IMMUNOLOGICAL SCREENING AS INFECTIOUS COMPLICATIONS PREDICTION METHOD IN PEDIATRIC CARDIAC SURGERY

Incidence of infectious complications in children with congenital heart disease, especially with cyanotic and complex defects, is higher than in the population, which is associated with both hemodynamic and immune disorders. Various types of primary immunodeficiencies in congenital heart disease and the dependence of immune disorders on the morphology of the defect, the severity of circulatory failure and arterial hypoxemia are described. The importance of diagnosing immunological disorders is emphasized to reduce the risk of infectious complications of cardiac surgery, reduce mortality and improve the outcomes of surgical interventions for congenital heart disease. The prognostic value of immune disorders identified by the TREC/KREC method for infectious complications of cardiac surgery has not been studied. The purpose of this research was to assess the possibility of predicting infectious complications of cardiac surgery in children with congenital heart disease based on screening using the TREC/KREC method. Material and methods used: preoperatively, 200 children with congenital heart disease aged 3 days to 12 months old were examined. Instrumental and laboratory methods were used including immunological screening for TREC/KREC DNA. Results: 123 (62.4%) were diagnosed with «acyanotic» congenital heart disease, 74 (37.5%) with various cyanotic congenital heart diseases and 10 (5%) with congenital heart diseases with Down syndrome, Di George syndrome, Williams syndrome or multiple malformations. 184 (92%) underwent various cardiac surgical interventions. Violations of T-cell immunity according to preoperative TREC/KREC screening were observed in 23.5% of cases including in all children with syndromic forms of congenital heart disease, multiple malformations, and significantly more often in cyanotic congenital heart disease, conotruncal defects, and those admitted in critical conditions. Infectious complications of cardiac surgery were observed significantly more often in this group than in children with normal T-cell immunity (in 36% and 3.6%, respectively). Conclusion: the prognostic value of TREC/KREC screening for targeted preparation and postoperative management in order to prevent infectious complications of cardiac surgery has been confirmed. © 2024, Pediatria Ltd.. All rights reserved.

Авторы
Degtyareva E.A. , Mwela B.M. , Kudlay D.A. , Ovsyannikov D.Yu. , Kantemirova M.G. , Prodeus A.P. , Kim A.I. , Nefedova I.E. , Rogova T.V. , Tumanyan M.R. , Alexeeva O.V. , Korsunsky I.A.
Номер выпуска
1
Язык
Русский
Страницы
87-94
Статус
Опубликовано
Том
103
Год
2024
Организации
  • 1 RUDN University, Moscow, Russian Federation
  • 2 I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
  • 3 M.V. Lomonosov Moscow State University, Moscow, Russian Federation
  • 4 Research and Clinical Institute of Childhood with the Moscow Oblast Healthcare Ministry, Moscow Oblast, Mytishchi, Russian Federation
  • 5 A.N. Bakulev Scientific Center for Cardiovascular Surgery, Moscow, Russian Federation
  • 6 HaEmek Medical Center, Northern District, Afula, Israel
Ключевые слова
cardiac surgery; congenital heart defects; immunity studies; immunological deficiency; infectious complications; KREC; primary immunodeficiencies; TREC
Цитировать
Поделиться

Другие записи

Shipilov A.
Электронный научно-образовательный журнал "История". Институт всеобщей истории РАН, Государственный академический университет гуманитарных наук, ООО "Интеграция: Образование и Наука". Том 15. 2024.