Does preoperative mechanical ventilation affect outcomes in neonates undergoing cardiac surgery?
OBJECTIVE
To review, in retrospective fashion, the effect of preoperative mechanical ventilation on neonatal outcomes after cardiac surgery.


METHODS
We studied 114 newborns less than 15 days old admitted to the cardiac intensive care unit for cardiac surgery. Of the newborns, 71 (62%) were mechanically ventilated at the referring hospital before transport to our institution. Of the 71 ventilated patients, 14 were extubated and breathing spontaneously before cardiac surgery. We compared variable haemodynamics and outcomes between the 57 patients mechanically ventilated at time of cardiac surgery, and the 57 patients breathing spontaneously at this time.


RESULTS
Newborns mechanically ventilated before cardiac surgery had increased preoperative haemodynamic compromise, increased postoperative sepsis (p equal to 0.02) and mortality (p equal to 0.005) compared with those breathing spontaneously before cardiac surgery.


CONCLUSIONS
Newborns requiring preoperative mechanical ventilation had greater risk of postoperative morbidity and mortality. Heightened vigilance is warranted in this population of patients at high risk.
Simsic
Janet M
JM
Sibley Heart Center Cardiology/Children's Healthcare of Atlanta, Atlanta, Georgia 30341, USA. simsicj@kidsheart.com
Kanter
Kirk R
KR
Kirshbom
Paul M
PM
Cuadrado
Angel
A
D006348:Cardiac Surgical Procedures; D005260:Female; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome / Q000601:surgery*; D007231:Infant, Newborn; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology*; D011300:Preoperative Care; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000453:epidemiology; D016896:Treatment Outcome