The role of cardiopulmonary bypass on the early postoperative IGG levels: effect on the postoperative outcome in cardiac surgery patients

Objective: This study tried to elucidate the role of the cardiopulmonary bypass on the early postoperative immunoglobulin G levels and any probable effects on the postoperative outcome of the patients.
Methods: 99 consecutive patients were studied. The evening after surgery the level of the IgG was obtained. The postoperative course of each patient during the first three days was followed. One way ANOVA was used for statistical analysis.
Results:  20 (20.2%) patients had decreased early postoperative immunoglobulin G levels. 87 (87.87%) patients were operated with cardiopulmonary bypass and 17 (19.54%) of them had lower levels of postoperative immunoglobulin G.
The statistical analysis between the two groups included: pulmonary infiltrations, leukocytosis >15x103/mm3, pulmonary dysfunction, mechanical ventilation >24h, renal and hepatic dysfunction, postoperative ileus, postoperative delirium, sternal wound infection, thrombocytopenia<60x103/mm3 and sepsis. The statistical results were: p=0.8145, p=0.8844, p=0.9360, p=0.3032, p=0.6766, p=0.1394, p=0.8403, p=0.3890, p=0.7658 respectively.
Conclusion: In this pilot study we tried to explore the role of cardiopulmonary bypass on the early postoperative levels of IgG and to establish any correlation with the postoperative outcome. The use of CPB and its duration did not prove to be risk factors for low early postoperative IgG levels. 20.2% of all the cardiac surgery patients who were operated electively or urgently and 19.54% of them who were operated with cardiopulmonary bypass had low early postoperative IgG levels, without any significant increased clinically adverse events. In our opinion the prophylactic use of IVIG in this group of patients has no benefit.