Vacunación en el niño con cardiopatías congénitas

El paciente pediátrico con cardiopatía debe ser vacunado como el resto de niños, modificándose el calendario en caso de tener una enfermedad aguda intercurrente.

En los niños con cardiopatía que no ha sido tratada correctamente y presentan enfermedad residual crónica, parece recomendado la administración de una vacuna antigripal todos los años.

Las recomendaciones actuales son: para los niños mayores de 8 años, 1 dosis intramuscular de 0,5 ml repitiéndose todos los años. En los niños de menos de 36 meses se debe administrar 1 dosis de 0,25 ml. En los niños entre 36 meses y 8 años, se administra 1 dosis de 0,5 ml, repitiéndose la misma dosis a las 4 semanas, en el caso de que sea la primera vez que se vacuna el paciente, posteriormente se administrara una dosis anual.


Bibliografía recomendada

1. Signorelli C, D'Alessandro D, Collina D, Fara GM. Prevalence survey of nosocomial infections in a paediatric hospital. J Hosp Infect. 1991; 18: 139-43.
2. Campins M, Vaque J, Rossello J, Salcedo S, Duran M, Monge V, Garcia Caballero J, Saenz MC, Calbo F, Armadans L. Nosocomial infections in pediatric patients: a prevalence study in Spanish hospitals. EPINE Working Group. Am J Infect Control. 1993; 21: 58-63.
3. Levy I, Ovadia B, Erez E, Rinat S, Ashkenazi S, Birk E, Konisberger H, Vidne B, Dagan O. Nosocomial infections after cardiac surgery in infants and children: incidence and risk factors. J Hosp Infect. 2003; 53: 111-6.
4. Valera M, Scolfaro C, Cappello N, Gramaglia E, Grassitelli S, Abbate MT, Rizzo A, Abbruzzese P, Valori A, Longo S, Tovo PA. Nosocomial infections in pediatric cardiac surgery, Italy. Infect Control Hosp Epidemiol. 2001; 22: 771-5.
5. Singh-Naz N, Sprague BM, Patel KM, Pollack MM. Risk assessment and standardized nosocomial infection rate in critically ill children. Crit Care Med. 2000; 28: 2069-75.
6. Raymond J, Aujard Y. Nosocomial infections in pediatric patients: a European, multicenter prospective study. European Study Group. Infect Control Hosp Epidemiol. 2000; 21: 260-3.
7. Richards MJ, Edwards JR, Culver DH, Gaynes RP. Nosocomial infections in pediatric intensive care units in the United States. National Nosocomial Infections Surveillance System. Pediatrics. 1999; 103:e39.
8. Montgomery VL, Strotman JM, Ross MP. Impact of multiple organ system dysfunction and nosocomial infections on survival of children treated with extracorporeal membrane oxygenation after heart surgery. Crit Care Med. 2000; 28: 526-31.
9. Dagan O, Cox PN, Ford-Jones L, Ponsonby J, Bohn DJ. Nosocomial infection following cardiovascular surgery: comparison of two periods, 1987 vs. 1992. Crit Care Med. 1999; 27:104-8.
10. Archibald LK, Manning ML, Bell LM, Banerjee S, Jarvis WR. Patient density, nurse-to-patient ratio and nosocomial infection risk in a pediatric cardiac intensive care unit. Pediatr Infect Dis J. 1997; 16: 1045-8.
11. Urrea M, Pons M, Serra M, Latorre C, Palomeque A. Prospective incidence study of nosocomial infections in a pediatric intensive care unit. Pediatr Infect Dis J. 2003; 22: 490-4.
12. Ottino G, De Paulis R, Pansini S, Rocca G, Tallone MV, Comoglio C, Costa P, Orzan F, Morea M. Major sternal wound infection after open-heart surgery: a multivariate analysis of risk factors in 2,579 consecutive operative procedures. Ann Thorac Surg. 1987; 44:173-9.
13. Mehta PA, Cunningham CK, Colella CB, Alferis G, Weiner LB. Risk factors for sternal wound and other infections in pediatric cardiac surgery patients. Pediatr Infect Dis J. 2000; 19: 1000-4.
14. Horwitz JR, Chwals WJ, Doski JJ, Suescun EA, Cheu HW, Lally KP. Pediatric wound infections: a prospective multicenter study. Ann Surg. 1998; 227: 553-8.
15. Damen J. The microbiologic risk of invasive haemodynamic monitoring in open-heart patients requiring prolonged ICU treatment. Intensive Care Med. 1988; 14: 156-62.
16. Brown KL, Ridout DA, Goldman AP, Hoskote A, Penny DJ. Risk factors for long intensive care unit stay after cardiopulmonary bypass in children. Crit Care Med. 2003; 31: 28-33.
17. Simchen E, Shapiro M, Marin G, Sacks T, Michel J. Risk factors for post-operative wound infection in cardiac surgery patients. Infect Control. 1983; 4: 215-20.
18. Rutledge R, Applebaum RE, Kim BJ. Mediastinal infection after open heart surgery. Surgery. 1985; 97: 88-92.
19. Damen J, Van der Tweel I. Positive tip cultures and related risk factors associated with intravascular catheterization in pediatric cardiac patients. Crit Care Med. 1988; 16: 221-8.
20. Ryan T, Mc Carthy JF, Rady MY, Serkey J, Gordon S, Starr NJ, Cosgrove DM. Early bloodstream infection after cardiopulmonary bypass: frequency rate, risk factors, and implications. Crit Care Med. 1997; 25: 2009-14.
21. Valera M, Scolfaro C, Cappello N, Gramaglia E, Grassitelli S, Abbate MT, Rizzo A, Abbruzzese P, Valori A, Longo S, Tovo PA. Nosocomial infections in pediatric cardiac surgery, Italy. Infect Control Hosp Epidemiol. 2001; 22: 771-5.
22. Moulton MJ, Creswell LL, Mackey ME, Cox JL, Rosenbloom M. Reexploration for bleeding is a risk factor for adverse outcomes after cardiac operations. J Thorac Cardiovasc Surg. 1996; 111: 1037-46.
23. Bhattacharyya N, Kosloske AM. Postoperative wound infection in pediatric surgical patients: a study of 676 infants and children. J Pediatr Surg. 1990; 25: 125-9.
24. Kohli M, Yuan L, Escobar M, David T, Gillis G, Comm B, Garcia M, Conly J. A risk index for sternal surgical wound infection after cardiovascular surgery. Infect Control Hosp Epidemiol. 2003; 24: 17-25.
25. Kac G, Durain E, Amrein C, Herisson E, Fiemeyer A, Buu-Hoi A. Colonization and infection of pulmonary artery catheter in cardiac surgery patients: epidemiology and multivariate analysis of risk factors. Crit Care Med. 2001; 29: 971-5.
26. Petaja J, Lundstrom U, Sairanen H, Marttinen E, Griffin JH. Central venous thrombosis after cardiac operations in children. J Thorac Cardiovasc Surg. 1996; 112: 883-9.
27. Tanaka K, Kumon K, Yamamoto F, Egoh Y, Naito Y, Fujita T. Respiratory care of pediatric patients requiring prolonged intubation after cardiac surgery. Crit Care Med. 1986; 14: 617-9.
28. Blanchard A, Hurni M, Ruchat P, Stumpe F, Fischer A, Sadeghi H. Incidence of deep and superficial sternal infection after open heart surgery. A ten years retrospective study from 1981 to 1991. Eur J Cardiothorac Surg. 1995; 9: 153-7.
29. Pollock EM, Ford-Jones EL, Rebeyka I, Mindorff CM, Bohn DJ, Edmonds JF, Lightfoot NE, Coles J, Williams WG, Trusler GA, et al. Early nosocomial infections in pediatric cardiovascular surgery patients. Crit Care Med. 1990; 18: 378-84.
30. Guay J, Rivard GE. Mediastinal bleeding after cardiopulmonary bypass in pediatric patients. Ann Thorac Surg. 1996; 62: 1955-60.
31. Ben-Abraham R, Efrati O, Mishali D, Yulia F, Vardi A, Barzilay Z, Paret G. Predictors for mortality after prolonged mechanical ventilation after cardiac surgery in children. J Crit Care. 2002; 17: 235-9.
32. McGee DC, Gould MK. Preventing complications of central venous catheterization. N Engl J Med 2003; 348: 1123-33.
33. Greenough A. Respiratory syncitial virus infection: clinical features, management, and prophylaxis. Curr Opin Pulm Med. 2002; 8: 214-7.
34. Pachon del Amo I. Calendario de vacunación infantil y recomendaciones de vacunación en adultos. Inf Ter Sist Nac Salud 2004; 28: 81-8.
35. Bridges CB, Harper SA, Fukuda K, Uyeki TM, Cox NJ, Singleton JA; Advisory Committee on Immunization Practices. Prevention and control of influenza. Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2003 ; 52: 1-34.
36. Schowengerdt KO, Naftel DC, Seib PM, Pearce FB, Addonizio LJ, Kirklin JK, Morrow WR. Infection after pediatric heart transplantation: results of a multiinstitutional study. The Pediatric Heart Transplant Study Group. J Heart Lung Transplant. 1997; 16: 1207-16.
37. Sondheimer HM, Cabalka AK, Feltes TF, Piazza FM, Connor EM and the Cardiac Synagis Study Group. Palivizumab reduces hospitalization due to respiratory syncytial virus in young children with serious congenital heart disease. Presented at the AAP 2002 National Conference, Section on Cardiology & Cardiac Surgery Program for Scientific Sessions, Boston, MA, USA. 18 th October 2002.
38. Dellinger RP, Carlet JM, Masur H, Gerlach H, Calandra T, Cohen J, Gea-Banacloche J, Keh D, Marshall JC, Parker MM, Ramsay G, Zimmerman JL, Vincent JL, Levy MM. Surviving Sepsis Campaign Management Guidelines Committee. Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock. Crit Care Med. 2004; 32: 858-73.
39. Levy I, Ovadia B, Erez E, Rinat S, Ashkenazi S, Birk E, Konisberger H, Vidne B, Dagan O. Nosocomial infections after cardiac surgery in infants and children: incidence and risk factors. J Hosp Infect. 2003; 53: 111-6.

 

volver