Mediastinitis in cardiovascular surgery postoperation. Analysis of 1038 consecutive surgeries

作者：Barros de Oliveira Sa Michel Pompeu; Silva Debora Oliveira; de Souza Lima Erika Nibbering; Lima Ricardo de Carvalho; Vasconcelos Silva Frederico Pires; de Rueda Fabio Goncalves; de Escobar Rodrigo Renda; Ferraz Cavalcanti Paulo Emando

来源：Brazilian Journal of Cardiovascular Surgery, 2010, 25(1): 19-24.

DOI：10.1590/S0102-76382010000100008

• Infection
• Mediastinitis
• Cardiac surgical procedures

Objective: To report the incidence of mediastinitis in cardiovascular surgery postoperation.
Methods: The records of all 1038 patients who underwent cardiovascular surgical procedures between May/2007 and June/2009 were reviewed. All operations were performed in Division of Cardiovascular Surgery of Pronto Socorro Cardiologico de Pernambuco - PROCAPE.
Results: The complication occurred within, on average, 13 days after operation, in total of 25(2.4%), eight (32%) deaths occurred. Several risk factors mediastinitis were identified: 56% diabetes, 56% smokers, 20% obeses, 16% with chronic obstructive pulmonary disease and 8% of chronic renal failure. Mediastinitis were reported in 21 (84%) cases of patients submitted to coronary artery bypass grafting, being associated to major risk of infection development (IC 3.44-8.30, P=0.0001). High rates of complications were observed: respiratory insufficiency (44%), stroke (16%), cardiogenic shock (12%), acute renal failure (28%), pulmonary infection (36%), multiple organs failure (16%) and esternal deiscence (48%). Bacterial cultures of exudates were positive in 84% of patients; Staphylococcus aureus was the most responsible pathogen (28.8%).
Conclusion: Mediastinitis stays a serious surgical complication and difficult management in cardiovascular surgery postoperation. The disease stays with low incidence, but still with high lethality. Coronary bypass was associated to major risk of infection development.

• 出版日期2010-3