Yasemin Yavuz1, Fatma Ukil Isildak1, Seda Arisut1, Abdullah Arif Yilmaz2, Fusun Guzelmeric1

1Istanbul Provincial Health Directorate Kartal Kosuyolu High Speciality Educational And Research Hospital, Department Of Anesthesia And Reanimation, Istanbul, Turkey
2Istanbul Provincial Health Directorate Kartal Kosuyolu High Speciality Educational And Research Hospital, Department Of Pediatric Cardiovascular Surgery, Istanbul, Turkey

Keywords: child, heart surgery, postoperative complications, inflammation, theophylline

Abstract

Objectives: The aim of this study was to evaluate the effects of intraoperative and postoperative theophylline infusion on inflammation in children who underwent open heart surgery with cardiopulmonary bypass (CPB) for congenital heart diseases.

Patients and Methods: This randomized controlled study was carried out with 140 children who underwent open heart surgery with CPB in a tertiary hospital. The patients were randomly enrolled into two groups (theophylline group= 70, control group= 70). Following the induction of anesthesia, theophylline infusion was applied to theophylline recipients from the beginning of the operation to the end of the 24th hour after surgery via a central venous catheter (CVC). The patients in the control group were infused with 0.9% NaCl solution at the same volume and duration via CVC.

Results: Postoperative red blood cell distribution width was significantly higher than preoperative values in the theophylline group (p= 0.003), but no significant difference was found in the control group (p= 0.188). In both groups, postoperative vasoactive-inotropic scores, and lymphocyte and platelet counts were lower than preoperative measurements (p<0.001 for each in both groups). While preoperative white blood cell counts were similar, postoperative values were found to be lower in the theophylline group (p= 0.022).

Conclusion: In pediatric patients undergoing open heart surgery with CPB, the use of intraoperative and postoperative theophylline may be effective in reducing postoperative inflammation, as demonstrated by lower white blood cell counts; but it does not significantly affect other clinical features.