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Ann Thorac Surg 2004;77:756
© 2004 The Society of Thoracic Surgeons

Correspondence

Cefazolin prophylaxis during cardiac operations: Reply

Bruce J. Leavitt, MD, Erika K. Fellinger, MD, James C. Hebert, MD

Department of Surgery, University of Vermont, Fletcher House 454, 111 Colchester Ave, Burlington, VT 05401, USA

e-mail: bruce.leavitt{at}vtmednet.org

To the Editor:

Our conclusions are similar to those of Dr Lehot in that it is unclear if current dosage regimens of cefazolin sodium produce adequate blood levels [1]. His results are similar to ours in that the levels of cefazolin are consistently greater than 4 µg/mL. Still, the levels fall shy of the minimum inhibitory concentration for pathogens such as Enterobacter and Serratia. Clearly, cefazolin levels will fluctuate depending on the amount and the nature of the priming volume. Our practice has been that of moderate hypothermia to 28°C during bypass with rewarming once the cross-clamp has been removed. Standard crystalloid prime with 1.5 L of Ringer's lactate is used at our institution. In light of the recent trend to perform off-pump coronary artery bypass grafting, we are in the process of a similar study involving cefazolin levels in this group of patients.

References

  1. Fellinger E.K., Leavitt B.J., Hebert J.C. Serum levels of prophylactic cefazolin during cardiopulmonary bypass surgery. Ann Thorac Surg 2002;74:1187-1190.[Abstract/Free Full Text]




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