Immune Function and Infection Risk After Pediatric Cardiac Surgery

2.50
Hdl Handle:
http://hdl.handle.net/10755/620278
Category:
Full-text
Type:
Poster
Title:
Immune Function and Infection Risk After Pediatric Cardiac Surgery
Author(s):
Greathouse, Kristin; Yates, Andrew; Harrison, Tondi M.; Anderson, Cindy; Wold, Loren; Hall, Mark
Lead Author STTI Affiliation:
Rho Nu-at-Large
Author Details:
Kristin Greathouse, CPNP-AC, greathouse.27@osu.edu; Andrew Yates, MD; Tondi M. Harrison, RN, CPNP; Cindy Anderson, RN, WHNP-BC, FAHA, FNAP, FAAN; Loren Wold, FAHA, FAPS; Mark Hall, FCCM
Abstract:
Session presented on Sunday, September 18, 2016: Infections occur in up to 20% of pediatric patients who undergo cardiac surgery. Post-operative infections are a significant source of additional morbidity, and can result in re-operations, lengthen hospital stays, and necessitate longer durations of mechanical ventilation and inotropic support. Proper immune function is vital for prevention�of post-operative infections. Two arms of the immune system operate together to maintain suitable function. First, the innate immune system serves as the key regulator of the inflammatory response that activates other immune cells and facilities repair of injured tissues. Second, the adaptive immune response confers specificity to the immune response and their cells typically require presentation of antigen by a member of the innate immune system in order to become activated. The combination of local trauma, cardiopulmonary bypass as well as pulmonary and myocardial reperfusion results in a significant systemic inflammatory response post-cardiac surgery. The compensatory anti-inflammatory response syndrome is activated to counteract this pro-inflammatory surge. This involves the elaboration of anti-inflammatory mediators resulting in down-regulation of the pro-inflammatory response and inhibition of leukocyte function. If the compensatory anti-inflammatory response is severe and persistent, it represents a form of secondary immune deficiency, which can profoundly affect immune function. This immune suppression has been demonstrated in critically ill children and adults following sepsis, trauma, and severe viral infections, and is also evident post-cardiac surgery. It is currently unknown how cardiac surgery impacts both innate and adaptive immune function in pediatric patients. Therefore, the purpose of this study is to gather data in pediatric cardiac surgery patients and demonstrate the incidence of cardiac surgery induced immune suppression. In addition, this study will be the first of its kind to evaluate innate and adaptive immune function and determine their relevance to post-surgical outcomes, namely infection. The study described will test the hypotheses that: 1) Cardiac surgery will be associated with a reduction in innate and adaptive immune function in comparison to pre-operative function, with those undergoing cardiopulmonary bypass having the most severe reduction, and 2) Severe, early reductions in innate and adaptive immune function will be associated with increased risk for the development of nosocomial infection.
Keywords:
cardiac; Immune; pediatric
Repository Posting Date:
16-Sep-2016
Date of Publication:
16-Sep-2016
Other Identifiers:
LEAD16PST29
Conference Date:
2016
Conference Name:
Leadership Connection 2016
Conference Host:
Sigma Theta Tau International
Conference Location:
Indianapolis, Indiana, USA
Description:
Leadership Connection 2016 Theme: Personal. Professional. Global. Held at the Marriott Downtown, Indianapolis.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen
dc.type.categoryFull-texten
dc.typePosteren
dc.titleImmune Function and Infection Risk After Pediatric Cardiac Surgeryen
dc.contributor.authorGreathouse, Kristinen
dc.contributor.authorYates, Andrewen
dc.contributor.authorHarrison, Tondi M.en
dc.contributor.authorAnderson, Cindyen
dc.contributor.authorWold, Lorenen
dc.contributor.authorHall, Marken
dc.contributor.departmentRho Nu-at-Largeen
dc.author.detailsKristin Greathouse, CPNP-AC, greathouse.27@osu.edu; Andrew Yates, MD; Tondi M. Harrison, RN, CPNP; Cindy Anderson, RN, WHNP-BC, FAHA, FNAP, FAAN; Loren Wold, FAHA, FAPS; Mark Hall, FCCMen
dc.identifier.urihttp://hdl.handle.net/10755/620278-
dc.description.abstractSession presented on Sunday, September 18, 2016: Infections occur in up to 20% of pediatric patients who undergo cardiac surgery. Post-operative infections are a significant source of additional morbidity, and can result in re-operations, lengthen hospital stays, and necessitate longer durations of mechanical ventilation and inotropic support. Proper immune function is vital for prevention�of post-operative infections. Two arms of the immune system operate together to maintain suitable function. First, the innate immune system serves as the key regulator of the inflammatory response that activates other immune cells and facilities repair of injured tissues. Second, the adaptive immune response confers specificity to the immune response and their cells typically require presentation of antigen by a member of the innate immune system in order to become activated. The combination of local trauma, cardiopulmonary bypass as well as pulmonary and myocardial reperfusion results in a significant systemic inflammatory response post-cardiac surgery. The compensatory anti-inflammatory response syndrome is activated to counteract this pro-inflammatory surge. This involves the elaboration of anti-inflammatory mediators resulting in down-regulation of the pro-inflammatory response and inhibition of leukocyte function. If the compensatory anti-inflammatory response is severe and persistent, it represents a form of secondary immune deficiency, which can profoundly affect immune function. This immune suppression has been demonstrated in critically ill children and adults following sepsis, trauma, and severe viral infections, and is also evident post-cardiac surgery. It is currently unknown how cardiac surgery impacts both innate and adaptive immune function in pediatric patients. Therefore, the purpose of this study is to gather data in pediatric cardiac surgery patients and demonstrate the incidence of cardiac surgery induced immune suppression. In addition, this study will be the first of its kind to evaluate innate and adaptive immune function and determine their relevance to post-surgical outcomes, namely infection. The study described will test the hypotheses that: 1) Cardiac surgery will be associated with a reduction in innate and adaptive immune function in comparison to pre-operative function, with those undergoing cardiopulmonary bypass having the most severe reduction, and 2) Severe, early reductions in innate and adaptive immune function will be associated with increased risk for the development of nosocomial infection.en
dc.subjectcardiacen
dc.subjectImmuneen
dc.subjectpediatricen
dc.date.available2016-09-16T14:23:37Z-
dc.date.issued2016-09-16-
dc.date.accessioned2016-09-16T14:23:37Z-
dc.conference.date2016en
dc.conference.nameLeadership Connection 2016en
dc.conference.hostSigma Theta Tau Internationalen
dc.conference.locationIndianapolis, Indiana, USAen
dc.descriptionLeadership Connection 2016 Theme: Personal. Professional. Global. Held at the Marriott Downtown, Indianapolis.en
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