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American Academy of Pediatrics National Conference and Exhibition
October 12, 2014
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Childhood immunization guidelines needed for cardiopulmonary bypass

SAN DIEGO — Immunization guidelines need to be developed for children with congenital heart disease before and after cardiopulmonary bypass, according to findings presented at the 2014 AAP National Conference and Exhibition.

“Congenital heart disease (CHD) occurs in approximately 1% of live births, making heart defects the most common birth defect,” the researchers wrote in the abstract. “Palliative cardiac procedures requiring cardiopulmonary bypass (CPB) are frequently performed during infancy. Immunization of infants is critical to their health, and potential scheduling conflicts arise between timing of surgical interventions and maintenance of an immunization schedule. Currently there are no guidelines for the administration of immunizations before or after CPB.”

Sabrina A. Carrillo, MD, MPH, and colleagues from the University of Texas Health Science Center, conducted a cross-sectional survey from August 2013 to January 2014 at 73 pediatric heart programs across the United States to determine the current immunization practices before and after CBP.

Overall, 30% of the institutions responded to the survey and more than half (55%) performed between 151 and 250 pediatric bypass surgeries per year. Seventy percent of institutions did not have a protocol for immunization administration; those with larger programs (>250 CPB cases annually) were less likely.

The most commonly reported reason for withholding immunizations following CPB was concern of postoperative fever (50%), followed by post-bypass immune modulation inhibiting an adequate immune response (36%) and administration of blood products (5%).

“These findings suggest no consensus or guidance in the administration of immunizations in children with [congenital heart disease] before and after CPB,” the researchers wrote. “Therefore, this population of high-risk children becomes even more vulnerable. Additional studies are needed to develop guidelines for the immunization of children undergoing [cardiopulmonary bypass].”

For more information:

Carrillo SA. #25864. Presented at: 2014 AAP National Conference and Exhibition; Oct. 10-13, 2014; San Diego.

Disclosure: Infectious Diseases in Children was unable to confirm any relevant financial disclosures.