The Effect of Perioperative and Postoperative Theophylline Administration on Inflammation in Patients Undergoing Pediatric Open-Heart Surgery
Yasemin Yavuz1, Fatma Ukil Işıldak1, Seda Arısüt1, Abdullah Arif Yılmaz2, Füsun Güzelmeriç1
1Department of Anesthesiology and Reanimation, Kartal Koşuyolu High Specialization Training and Research Hospital, Istanbul, Turkey
2Department of Pediatric Cardiovascular Surgery, Kartal Koşuyolu High Specialization Training and Research Hospital, Istanbul, Turkey
Keywords: Child; heart surgery; inflammation; theophylline.
Introduction: The aim of this study was to evaluate the effects of intraoperative and postoperative theophyl- line 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 (the- ophylline 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 post- operative 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.