{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:15:06Z","timestamp":1787022906705,"version":"build-2736575974"},"reference-count":18,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,1,1]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Infants with congenital heart disease remain vulnerable to potentially preventable pathogens. Although immunization can significantly reduce this risk, it is unknown how immunization status can be affected by cardiac surgery with cardiopulmonary bypass (CPB). The objective was to evaluate the effect of CPB on infant vaccination status after cardiac surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>We conducted a prospective observational study of patients between 2 and 14 months of age who had received at least their first round of infant vaccinations and who required cardiac surgery with CPB. Antibody titers were measured before CPB and again the following morning. Demographic and surgical variables were assessed via regression methods for their effects on the change in titers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>Among the 98 patients followed, there was no demonstrated difference between the pre- and postoperative values in regard to diphtheria, tetanus, polio 1, polio 3, or Haemophilus influenzae titers. Bordetella (1.03 vs 0.84, P &amp;lt; .001), and hepatitis B (log 2.10 vs 1.89, P = .001) titers did reduce after CPB but did not fall below the immunized threshold. Changes in antibody titers were not associated with time between immunization and surgery, age or weight at surgery, blood products administered, number of previous doses, time on CPB, or heterotaxy diagnosis for most of the vaccines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Infant vaccine antibody titers were minimally affected by CPB and not associated with any easily modifiable surgical variables. Although antibody titers are only 1 marker of immunity, deviation from the recommended vaccination schedule may be unnecessary for children requiring congenital heart surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/peds.2019-1716","type":"journal-article","created":{"date-parts":[[2019,12,4]],"date-time":"2019-12-04T08:25:12Z","timestamp":1575447912000},"source":"Crossref","is-referenced-by-count":8,"title":["Cardiopulmonary Bypass and Infant Vaccination Titers"],"prefix":"10.1542","volume":"145","author":[{"given":"Jeffrey","family":"Vergales","sequence":"first","affiliation":[{"name":"aDivisions of Pediatric Cardiology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Dean","sequence":"additional","affiliation":[{"name":"aDivisions of Pediatric Cardiology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Raphael","sequence":"additional","affiliation":[{"name":"bDepartment of Anesthesiology, University of Virginia, Charlottesville, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Frank","sequence":"additional","affiliation":[{"name":"cCritical Care, Department of Pediatrics,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adishesh","family":"Narahari","sequence":"additional","affiliation":[{"name":"aDivisions of Pediatric Cardiology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tyson","family":"Hekking","sequence":"additional","affiliation":[{"name":"aDivisions of Pediatric Cardiology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol Ann","family":"Rosenberg","sequence":"additional","affiliation":[{"name":"dDivision of Cardiothoracic Surgery, Department of Surgery, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Roeser","sequence":"additional","affiliation":[{"name":"dDivision of Cardiothoracic Surgery, Department of Surgery, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Gangemi","sequence":"additional","affiliation":[{"name":"dDivision of Cardiothoracic Surgery, Department of Surgery, and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2020,1,1]]},"reference":[{"issue":"3","key":"2022091216100801100_B1","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1016\/j.athoracsur.2014.04.127","article-title":"Congenital heart operations performed in the first year of life: does geographic variation exist?","volume":"98","author":"Husain","year":"2014","journal-title":"Ann Thorac Surg"},{"issue":"4","key":"2022091216100801100_B2","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1067\/S0022-3476(03)00454-2","article-title":"Palivizumab prophylaxis reduces hospitalization due to respiratory syncytial virus in young children with hemodynamically significant congenital heart disease","volume":"143","author":"Feltes","year":"2003","journal-title":"J Pediatr"},{"issue":"11","key":"2022091216100801100_B3","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1111\/j.1525-1594.2010.01133.x","article-title":"Inflammatory and hemostatic response to cardiopulmonary bypass in pediatric population: feasibility of seriological testing of multiple biomarkers","volume":"34","author":"A\u011dirba\u015fli","year":"2010","journal-title":"Artif Organs"},{"issue":"4","key":"2022091216100801100_B4","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1007\/s00246-006-0934-y","article-title":"Cytokine response in children undergoing surgery for congenital heart disease","volume":"27","author":"Madhok","year":"2006","journal-title":"Pediatr Cardiol"},{"issue":"6","key":"2022091216100801100_B5","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1203\/PDR.0b013e31816e391f","article-title":"Plasma biomarkers in pediatric patients undergoing cardiopulmonary bypass","volume":"63","author":"Lull","year":"2008","journal-title":"Pediatr Res"},{"issue":"3","key":"2022091216100801100_B6","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1016\/S0022-5223(96)70306-9","article-title":"Interleukin-10 release related to cardiopulmonary bypass in infants undergoing cardiac operations","volume":"111","author":"Seghaye","year":"1996","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"5","key":"2022091216100801100_B7","first-page":"453","article-title":"Immunization of children with congenital heart disease undergoing cardiopulmonary bypass","volume":"9","author":"Carrillo","year":"2014","journal-title":"Congenit Heart Dis"},{"key":"2022091216100801100_B8","unstructured":"Centers for Disease Control and Prevention. Immunization schedules. 2018. Available at: https:\/\/www.cdc.gov\/vaccines\/schedules\/index.html. Accessed January 8, 2018"},{"issue":"8","key":"2022091216100801100_B9","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1111\/ped.12899","article-title":"Timing of Haemophilus influenzae type b vaccination after cardiac surgery","volume":"58","author":"Takanashi","year":"2016","journal-title":"Pediatr Int (Roma)"},{"key":"2022091216100801100_B10","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1097\/00024382-200116001-00006","article-title":"Pediatric cardiac surgery with cardiopulmonary bypass: pathways contributing to transient systemic immune suppression","volume":"16","author":"Tarnok","year":"2001","journal-title":"Shock"},{"issue":"1","key":"2022091216100801100_B11","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1007\/s00431-001-0892-6","article-title":"Changes in lymphocyte subsets after cardiac surgery in children","volume":"162","author":"Habermehl","year":"2003","journal-title":"Eur J Pediatr"},{"issue":"3","key":"2022091216100801100_B12","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1016\/0003-4975(93)90265-J","article-title":"Cardiopulmonary bypass and cellular immunity: changes in lymphocyte subsets and natural killer cell activity","volume":"55","author":"Tajima","year":"1993","journal-title":"Ann Thorac Surg"},{"issue":"2","key":"2022091216100801100_B13","first-page":"415","article-title":"Updated guidance for palivizumab prophylaxis among infants and young children at increased risk of hospitalization for respiratory syncytial virus infection [published correction appears in Pediatrics. 2014;134(6):1221]","volume":"134","author":"American Academy of Pediatrics Committee on Infectious Diseases","year":"2014","journal-title":"Pediatrics"},{"key":"2022091216100801100_B14","volume-title":"Plotkin\u2019s Vaccines","author":"Siegrist","year":"2018","edition":"7th ed"},{"issue":"3","key":"2022091216100801100_B15","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1038\/nri3804","article-title":"Dynamics of B cells in germinal centres","volume":"15","author":"De Silva","year":"2015","journal-title":"Nat Rev Immunol"},{"issue":"2","key":"2022091216100801100_B16","first-page":"106","article-title":"Non-responders to hepatitis B vaccination: a review","volume":"6","author":"Kubba","year":"2003","journal-title":"Commun Dis Public Health"},{"issue":"13\u201314","key":"2022091216100801100_B17","doi-asserted-by":"crossref","first-page":"1671","DOI":"10.1016\/S0264-410X(00)00409-6","article-title":"Antibody responses to pneumococcal and haemophilus vaccinations in patients with B-cell chronic lymphocytic leukaemia","volume":"19","author":"Hartkamp","year":"2001","journal-title":"Vaccine"},{"key":"2022091216100801100_B18","doi-asserted-by":"crossref","first-page":"S41","DOI":"10.1097\/01.inf.0000108220.94201.1a","article-title":"Physiologic risk factors for respiratory viral infections and immunoprophylaxis for respiratory syncytial virus in young children with congenital heart disease","volume":"23","author":"Cabalka","year":"2004","journal-title":"Pediatr Infect Dis J"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2019-1716\/1367019\/peds_20191716.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2019-1716\/1367019\/peds_20191716.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,12]],"date-time":"2022-09-12T12:10:54Z","timestamp":1662984654000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/145\/1\/e20191716\/76885\/Cardiopulmonary-Bypass-and-Infant-Vaccination"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,1]]},"references-count":18,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2020,1,1]]},"published-print":{"date-parts":[[2020,1,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2019-1716","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,1]]},"article-number":"e20191716"}}