Correction of immune reactivity in cardiac surgery patients with deep sternal infection

The study was carried out in the period from 2010 to 2019 in 88 patients with sternomediastinitis after cardiac surgery (mean age 63.4±one year). Depending on the treatment tactics, the patients were divided into three groups: group 1 (comparisons, n=48) - the «traditional» method of treatment was used; group 2 (primary, n=20) - the technique of local negative pressure (vacuum therapy) was used as monotherapy; group 3 (primary, n=20) - vacuum therapy in combination with bacteriophages. In 10 patients from each group, randomly selected on the 3rd, 7th, and 14th days, venous blood sampling was performed to determine the dynamics of indicators of the immune status. Upon admission, all patients showed a decrease in the immunoregulatory index to 0.6±0.14 units (half the norm). In group 3, average indicators of cellular immunity were observed already from the 3rd day, the immunoregulatory index on the 7th day was 1.5 units. In groups 1 and 2 - mild compensatory dynamics, imbalance of CD4 and CD8 subpopulations of T-lymphocytes, immunosuppression. On the 14th day, the T- and B-lymphatic link cells, NK-cells, were at the lower limit of the norm, and the immunoregulatory index (1.2 units) did not reach optimal values. On the 7th and 14th days, normal immunological parameters were significantly more often detected in group 2 (p=0.05), on the 3rd, 7th, and 14th days - in group 3 (p=0.05).

deep sternal infection, postoperative sternomediastinitis, immune status, immunogram, immunodeficiency, immunoregulatory index