Faculty Collaboration Database

Pulmonary risk factors compromising postoperative recovery after surgical repair for congenital heart disease. Chest 1999 Sep;116(3):740-7

Date

09/24/1999

Pubmed ID

10492281

DOI

10.1378/chest.116.3.740

Scopus ID

2-s2.0-0032822966 (requires institutional sign-in at Scopus site)   71 Citations

Abstract

STUDY OBJECTIVES: To identify pulmonary risk factors associated with prolonged ICU stay in young children (< or = 2 years) undergoing surgical repair for congenital heart disease (CHD).

DESIGN: Retrospective case series analysis.

SETTING: Tertiary-care facility.

PATIENTS: Clinical records of 134 consecutive patients aged < or = 2 years undergoing cardiac surgery for CHD were reviewed, and 37 were excluded according to inclusion criteria. Thus, 97 patients were allocated to two groups based on the duration of ICU stay: < or = 7 days (group 1, n = 57), and > 7 days (group 2, n = 40).

RESULTS: Mean ICU duration for groups 1 and 2 was 3.0 +/- 0.4 days and 28.1 +/- 4.4 days, respectively (p < 0.001). In group 1, there were three extubation failures, whereas 41 extubation failures occurred in group 2 (p < 0.0001). A total of 22 patients (4 in group 1 and 18 in group 2) developed noninfectious pulmonary complications, such as airway problems, including extrinsic airway compression and tracheobronchomalacia (n = 6); pulmonary hypertension (n = 5); phrenic nerve palsy (n = 7); and pleural effusion (n = 8). These 22 patients (23%) contributed to the majority of total ventilator days (67%) as well as ICU stay (61%).

CONCLUSIONS: Pulmonary complications in general, and central airway problems in particular, are a frequent cause for delayed recovery following cardiac surgery in young children.

Author List

Bandla HP, Hopkins RL, Beckerman RC, Gozal D

Author

Hari Bandla MD Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Cardiac Surgical Procedures
Female
Heart Defects, Congenital
Humans
Hypertension, Pulmonary
Infant
Intensive Care Units
Length of Stay
Male
Pleural Effusion
Postoperative Complications
Respiration, Artificial
Respiratory Paralysis
Respiratory Tract Diseases
Retrospective Studies
Risk Factors