Factors prolonging length of stay in the cardiac intensive care unit following the arterial switch operation.
The arterial switch operation has become the preferred procedure for surgical management of transposition, defined on the basis of concordant atrioventricular and discordant ventriculo-arterial connections. We conducted a retrospective evaluation of our experience in 61 infants with this segmental combination, seen from January, 1997, to July, 2003, in order to determine the factors that are associated with a prolonged postoperative course. Factors independently associated with a prolonged postoperative stay in the cardiac intensive care unit included prematurity, difficulty in feeding, capillary leak, need for preoperative inotropic support, and postoperative infectious complications. Future research is warranted designed to minimize the impact of capillary leak and postoperative infectious complications. In addition, based on these results, our practice has evolved to initiate enteral feedings in the preoperative period if feasible, with such enteral feedings resumed as soon as possible following surgery.
Wheeler
Derek S
DS
Divisions of Critical Care Medicine, Cardiology, and Cardiothoracic Surgery, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.
Dent
Catherine L
CL
Manning
Peter B
PB
Nelson
David P
DP
D002300:Cardiac Care Facilities / Q000706:statistics & numerical data*; D006348:Cardiac Surgical Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D011184:Postoperative Period; D012189:Retrospective Studies; D012307:Risk Factors; D014188:Transposition of Great Vessels / Q000601:surgery*; D016896:Treatment Outcome