Pulmonary risk factors compromising postoperative recovery after surgical repair for congenital heart disease

被引:55
作者
Bandla, HPR
Hopkins, RL
Beckerman, RC
Gozal, D
机构
[1] Tulane Univ, Sch Med, Dept Pediat, Sect Pediat Pulmonol, New Orleans, LA 70112 USA
[2] Tulane Univ, Sch Med, Dept Pediat, Sect Crit Care, New Orleans, LA 70112 USA
关键词
cardiac surgery; congenital heart disease; flexible bronchoscopy; intensive care; mechanical ventilation; phrenic nerve palsy; respiratory morbidity; tracheobronchomalacia;
D O I
10.1378/chest.116.3.740
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
objectives: To identify pulmonary risk factors associated with prolonged ICU stay in young children (less than or equal to 2 years) undergoing surgical I repair for congenital heart disease (CHD), Design: Retrospective case series analysis. Setting: Tertialy-care facility, Patients: Clinical records of 134 consecutive, patients aged less than or equal to 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: less than or equal to 7 dais (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 11 extubation failures occurred in group 2 (p < 0,0.0001), A total of 22 patients (4 in group 1 and 18 in gl group 2) developed noninfectious pulmonary complications, such as airway, problems, including extrinsic airway compression and tracheobronchomal, (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.
引用
收藏
页码:740 / 747
页数:8
相关论文
共 37 条
[31]   CHYLOTHORAX - INDICATIONS FOR SURGERY [J].
SELLE, JG ;
SNYDER, WH ;
SCHREIBER, JT .
ANNALS OF SURGERY, 1973, 177 (02) :245-249
[32]  
STANGER P, 1969, PEDIATRICS, V43, P760
[33]   Clinical implications of phrenic nerve injury after pediatric cardiac surgery [J].
Tonz, M ;
vonSegesser, LK ;
Mihaljevic, T ;
Arbenz, U ;
Stauffer, UG ;
Turina, MI .
JOURNAL OF PEDIATRIC SURGERY, 1996, 31 (09) :1265-1267
[34]  
VERUNELLI F, 1983, J CARDIOVASC SURG, V24, P227
[35]  
WATANABE T, 1987, J THORAC CARDIOV SUR, V94, P383
[36]   DIAGNOSIS AND MANAGEMENT OF POST-OPERATIVE PULMONARY HYPERTENSIVE CRISIS [J].
WHELLER, J ;
GEORGE, BL ;
MULDER, DG ;
JARMAKANI, JM .
CIRCULATION, 1979, 60 (07) :1640-1644
[37]   POSTOPERATIVE UNILATERAL DIAPHRAGMATIC PARALYSIS IN CHILDREN, A PLEA FOR EARLY PLICATION [J].
YELLIN, A ;
LIEBERMAN, Y ;
BARZILAY, Z .
THORACIC AND CARDIOVASCULAR SURGEON, 1991, 39 (04) :221-223