Utility of blood cultures in postoperative pediatric intensive care unit patients*

Kiragu, Andrew; Zier, Judith L.; Cornfield, David N.

doi:10.1097/pcc.0b013e3181a31bb7

Cited by 22 publications

(9 citation statements)

References 24 publications

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“…Fever occurs in approximately 30% of children during the first 2 to 3 days following surgery. 6,7 Infection is rarely the source of the fever in this population at this time. In a study of 602 post-operative patients admitted to the PICU, 173 had a fever and 66 had blood cultures obtained.…”

Section: Fever In the Pediatric Cicumentioning

confidence: 86%

Immunologic and Infectious Diseases in Pediatric Cardiac Critical Care

Axelrod

Alten

Berger

et al. 2015

World J Pediatr Congenit Heart Surg

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Since the inception of the Pediatric Cardiac Intensive Care Society (PCICS) in 2003, remarkable advances in the care of children with critical cardiac disease have been developed. Specialized surgical approaches, anesthesiology practices, and intensive care management have all contributed to improved outcomes. However, significant morbidity often results from immunologic or infectious disease in the perioperative period or during a medical intensive care unit admission. The immunologic or infectious illness may lead to fever, which requires the attention and resources of the cardiac intensivist. Frequently, cardiopulmonary bypass leads to an inflammatory state that may present hemodynamic challenges or complicate postoperative care. However, inflammation unchecked by a compensatory anti-inflammatory response may also contribute to the development of capillary leak and lead to a complicated intensive care unit course. Any patient admitted to the intensive care unit is at risk for a hospital acquired infection, and no patients are at greater risk than the child treated with mechanical circulatory support. In summary, the prevention, diagnosis, and management of immunologic and infectious diseases in the pediatric cardiac intensive care unit is of paramount importance for the clinician. This review from the tenth PCICS International Conference will summarize the current knowledge in this important aspect of our field.

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Section: Fever In the Pediatric Cicumentioning

confidence: 86%

Immunologic and Infectious Diseases in Pediatric Cardiac Critical Care

Axelrod

Alten

Berger

et al. 2015

World J Pediatr Congenit Heart Surg

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“…4). Moreover, the higher incidence of postoperative fever following more extensive or trauma surgery may be caused by a greater degree of tissue inflammation 1,2,13) .…”

Section: Discussionmentioning

confidence: 99%

Postoperative Non-Pathological Fever Following Posterior Cervical Fusion Surgery : Is Laminoplasty a Better Preventive Method than Laminectomy?

Lee

Jung²,

Kim³

et al. 2020

J Korean Neurosurg Soc

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Objective : To analyze the incidence and characteristics of delayed postoperative fever in posterior cervical fusion using cervical pedicle screws (CPS). Methods : This study analyzed 119 patients who underwent posterior cervical fusion surgery using CPS. Delayed fever was defined as no fever for the first 3 postoperative days, followed by an ear temperature ≥38°C on postoperative day 4 and subsequent days. Patient age, sex, diagnosis, laminectomy, surgical level, revision status, body mass index, underlying medical disease, surgical duration, and transfusion status were retrospectively reviewed. Results : Of 119 patients, seven were excluded due to surgical site infection, spondylitis, pneumonia, or surgical level that included the thoracic spine. Of the 112 included patients, 28 (25%) were febrile and 84 (75%) were afebrile. Multivariate logistic regression analysis showed that laminectomy was a statistically significant risk factor for postoperative non-pathological fever (odds ratio, 10.251; p=0.000). In contrast, trauma or tumor surgery and underlying medical disease were not significant risk factors for fever. Conclusion : Patients who develop delayed fever 4 days after posterior cervical fusion surgery using CPS are more likely to have non-pathologic fever than surgical site infection. Laminectomy is a significant risk factor for non-pathologic fever.

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“…20,21 Studies in the PICU have been limited to the immediate postoperative period or to specific periods surrounding an educational campaign. 22,23 In contrast, we measured blood culture rates across staggered 3-to 4-year periods in multiple children's hospitals. Blood culture rates, which were 1.14 cultures per admission in the PICU and 1.32 cultures per admission in the NICU, were similar to the 0.3 to 1.7 cultures per admission or discharge in prior studies.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies of blood culture utilization have focused on inappropriate use in the emergency department, 17 , 18 outpatient clinic, 19 and neurosurgical ICU 20 21 Studies in the PICU have been limited to the immediate postoperative period or to specific periods surrounding an educational campaign 22 23 In contrast, we measured blood culture rates across staggered 3- to 4-year periods in multiple children’s hospitals.…”

Section: Discussionmentioning

confidence: 99%