[Risk factors for prolonged mechanical ventilation after cardiac surgery in children].
OBJECTIVE
To study the postoperative factors associated with prolonged mechanical ventilation after cardiac surgery in children.


METHODS
Prospective observational study.


METHODS
Pediatric intensive care unit (PICU).


METHODS
59 children aged between 2 months and 14 years after cardiac surgery.


METHODS
We analyzed postoperative parameters associated to mechanical ventilation lasting more than 3 and more than 7 days. We performed a stepwise multiple logistic regression analysis to study the influence of each factor on prolonged mechanical ventilation.


RESULTS
Mechanical ventilation lasted more than 3 days in 19 (32%) children and more than 7 days in 12 (20%). Predictive factors at PICU admission and 24 hours after admission associated with mechanical ventilation at 3 and 7 days were age less than 12 months, weight less than 7 kg, extrapulmonary complications (hypotension, arrhythmias, postoperative bleeding, delayed sternal closure, and airway complications), nitric oxide treatment, midazolam perfusion more than 4 microg/kg/min or fentanyl perfusion more than 4 microg/kg/h, and continuous muscle relaxant treatment. In the logistic multiple regression study, weight less than 7 kg and extrapulmonary complications predicted 82.8% of children with mechanical ventilation more than 3 days and 87.9% with mechanical ventilation more than 7 days.


CONCLUSIONS
Weight less than 7 kg and extrapulmonary complications are the most important factors associated with prolonged mechanical ventilation after cardiac surgery in children.
López-Herce Cid
Jesús
J
Sección de Cuidados Intensivos Pediátricos. Hospital General Universitario Gregorio Marañón. Madrid. España. pielvi@ya.com
Leyton Avilés
Pablo
P
Urbano Villaescusa
Javier
J
Cidoncha Escobar
Elena
E
Del Castillo Peral
Jimena
J
Carrillo Alvarez
Angel
A
Bellón Cano
José María
JM
D000293:Adolescent; D006348:Cardiac Surgical Procedures; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011182:Postoperative Care; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000706:statistics & numerical data*; D012307:Risk Factors; D013997:Time Factors