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ULTIMO FASCICOLOTHE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica

Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,632

Periodicità: Bimestrale

ISSN 0021-9509

Online ISSN 1827-191X

 

The Journal of Cardiovascular Surgery 1998 Febbraio;39(1):95-7

CARDIAC PAPERS 

 ORIGINAL ARTICLES

Man­age­ment of post­op­er­a­tive ­fever in car­di­o­vas­cular sur­gery

Ishikawa S., Ohtaki A., Takahashi T., Sato Y., Koyano T., Hasegawa Y., Yamagishi T., Ogino T., Ohki S., Kamiyushihara M., Morishita Y.

From the ­Second Depart­ment of Sur­gery, Gunma Uni­ver­sity ­School of Med­i­cine,Mae­bashi, ­Japan

Back­ground. The ­causes and man­age­ment of post­op­er­a­tive ­fever ­were ­studied.
Mate­rials and ­methods. ­During a ­four -year -period begin­ning in Jan­uary of 1991, ­high ­fever ­over 38.5°C max ­occurred in ­twenty-­five (6%) out of 395 ­patients who under­went car­di­o­vas­cular sur­gery.
Results. Nine of the ­patients (28%) evi­denced bac­te­ri­o­log­ical infec­tions as fol­lows; 3 ­cases of med­i­as­tin­itis, 2 ­cases of res­pir­a­tory ­tract infec­tion, 1 ­case of ­MRSA col­itis and a ­wound infec­tion in one ­case. The ­three ­patients ­with med­i­as­tin­itis ­died and the two ­cases of ­MRSA ­were ­detected ­from the cul­ture of pace­maker ­leads. Bac­te­ri­o­-log­ical infec­tion was not ­detected in ­other 18 (72%) ­patients ­with ­fever. How­ever, we spec­u­lated ­that the clin­ical ­causes of ­fever in 9 out of 18 ­patients ­were as fol­lows; cath­eter ­fever in 3 ­patients, acal­cu­lous chol­e­cys­titis in 2, ­fungus infec­tion in 2, ­aseptic men­in­gitis in one and ­viral mye­litis in one ­patient. Two ­patients ­with acal­cu­lous chol­e­cys­titis recov­ered ­after per­cut­aneous trans­he­patic gall­bladder ­drainage. The ­causes of ­fever ­were not ­apparent in ­nine ­patients, how­ever the ­source ­might be ­related to arti­fi­cial pros­theses ­used intra­op­er­a­tively in ­five ­patients. C-reac­tive pro­tein (CRP) was ele­vated ­beyond 10 mg/dl in 13 (52%) of the 25 ­patients. CRP ­increased in all ­seven bac­te­ri­o­log­i­cally pos­i­tive ­patients and in six (32%) of the bac­te­ri­o­log­i­cally neg­a­tive ­patients.
Con­clu­sions. Pre­cise and ­prompt bac­te­rial exam­ina­tions are nec­es­sary in ­patients ­with CRP ele­va­tion ­because the ori­gins of ­fever ­were bac­te­ri­o­log­ical in ­only 28% of the ­patients ­with a ­high ­fever. ­Good prog­noses may be ­obtained by suit­able man­age­ment in bac­te­ri­o­log­i­cally neg­a­tive ­patients.

lingua: Inglese


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