Pulmonary risk factors compromising postoperative recovery after surgical repair for congenital heart disease.
OBJECTIVE
To identify pulmonary risk factors associated with prolonged ICU stay in young children (< or = 2 years) undergoing surgical repair for congenital heart disease (CHD).


METHODS
Retrospective case series analysis.


METHODS
Tertiary-care facility.


METHODS
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.
Bandla
H P
HP
Department of Pediatrics, Tulane University School of Medicine, New Orleans, LA 70112, USA.
Hopkins
R L
RL
Beckerman
R C
RC
Gozal
D
D
D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology; D007223:Infant; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D010996:Pleural Effusion / Q000209:etiology; D011183:Postoperative Complications; D012121:Respiration, Artificial; D012133:Respiratory Paralysis / Q000209:etiology; D012140:Respiratory Tract Diseases / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors