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Evaluation of the Relationship Between Plasma Transfusion and Nosocomial Infection After Cardiac Surgery in Children Younger Than 1 Year*

Objectives: Recent data have suggested a link between plasma transfusion and the development of nosocomial infections in critically ill children. However, to our knowledge, no study has specifically focused on this association among children undergoing cardiac surgery. Thus, the main objective of this study was to analyze the relationship between plasma transfusion after cardiac surgery and the risk of nosocomial infections, including bloodstream infections, mediastinitis, and ventilator-associated pneumonia, in children younger than 1 year. Design: Observational single-center study. Setting: A 12-bed tertiary PICU in a university hospital in France. Patients: Children less than 1 year admitted after cardiac surgery under cardiopulmonary bypass between November 2007 and December 2012. Interventions: None. Measurements and Main Results: Data from 233 children were analyzed, of which 94 children (40%) had been transfused with plasma during their PICU stay. Fifty-six episodes of nosocomial infections (51 children) were reported, yielding a nosocomial infection ratio of 24%. The unadjusted odds ratio for developing nosocomial infections associated with plasma transfusion was 4.1 (95% CI, 2.1–7.9; p < 0.001). After adjusting for a propensity score, there was no difference between the two groups (adjusted odds ratio, 1.5; 95% CI, 0.5–4.0; p = 0.5). Conclusion: Plasma transfusion following cardiac surgery under cardiopulmonary bypass was not independently associated with the development of nosocomial infections in children (< 1 yr old) after adjustment for a propensity score.