Cardiology Letters 2016, 25(4):286-292

The impact of the use of extracorporeal circulation on the early postoperative IgG concentrations: potential effect on the outcome in cardiac surgery patients - pilot study

Artemiou P¹, Bilý B², Rabajdová M³, Pashalidis I⁴, Sabol F²

¹ Klinika kardiochirurgie, NÚSCH a. s., Bratislava, Slovenská republika

² Univerzita Pavla Jozefa Šafárika, Lekárska Fakulta, Klinika srdcovej chirurgie, VÚSCH a. s., Košice, Slovenská republika

³ Univerzita Pavla Jozefa Šafárika, Lekárska Fakulta, Ústav lekárskej a klinickej biochémie, Košice, Slovenská republika

⁴ Cyperská univerzita, Katedra chémie, Nikózia, Cyprus

Objective: This study tried to elucidate the role of the cardiopulmonary bypass on the early postoperative immunoglobulin G levels and any probable effects on the postoperative outcome of the patients.

Methods: A heterogeneous group for clinical study consisted of 117 consecutive patients. The evening after surgery the level of the IgG was obtained. The postoperative course of each patient during the first three days was followed. One way ANOVA was used for statistical analysis.

Results: Twenty patients (17.09%) had decreased early postoperative immunoglobulin G levels. One hundred and five patients (89.74%) were operated on with cardiopulmonary bypass and 17 (16.19%) of them had lower levels of postoperative immunoglobulin G. The statistical analysis between the two groups included: pulmonary infiltrations, leukocytosis >15x103/mm3, pulmonary dysfunction, mechanical ventilation >24h, renal and hepatic dysfunction, postoperative ileus, postoperative delirium, sternal wound infection, thrombocytopenia < 60x103/mm3 and sepsis. The statistical results were: p=0.8145, p=0.8844, p=0.9360, p=0.3032, p=0.6766, p=0.1394, p=0.8403, p=0.3890, p=0.7658, respectively.

Conclusion: In this clinical study we tried to explore the role of cardiopulmonary bypass on the early postoperative levels of IgG and to establish any correlation with the postoperative outcome. The use of CPB and its duration did not prove to be risk factors for low early postoperative IgG levels. From all of the cardiac surgery patients who were operated on electively or urgently, 16.19% of them who were operated on with cardiopulmonary bypass had low early postoperative IgG levels, without any significant increased clinicallyadverse events. In our opinion the prophylactic use of intravenous immunoglobulins in this group of patients has no benefit.

Keywords: postoperative complications; immunoglobulin G; cardiopulmonary bypass; cardiac surgery

Published: April 1, 2016  Show citation