Incidence and risk factors for postoperative vomiting following atrial septal defect repair in children.
The incidence and risk factors for postoperative vomiting (POV) after pediatric cardiac surgery has not been studied.



This study sought to assess the incidence and risk factors for POV in children undergoing surgical repair of an atrial septal defect (ASD).



We retrospectively collected perioperative data from 160 patients who underwent surgical repair of an ASD and met early extubation criteria. Demographic and clinical data that could potentially influence the incidence of POV were collected. Univariate analysis was performed using Student t-test or Wilcoxon rank test to identify factors associated with POV. Continuous variables were dichotomized based on the cutoff values derived from the receiver operating characteristic (ROC) curve analysis and the Youden-J index. We used multivariate logistic regression analysis using backward selection to determine the independent predictors using a univariate cutoff of P < 0.10 for inclusion and P > 0.05 for removal to determine factors independently associated with POV. The accuracy of our multivariate model was assessed by the area under the ROC curve (AUC).



Overall the incidence of POV was 37.5% in all the children who underwent surgical ASD repair. POV did not significantly differ between patients who received and did not receive antiemetics intraoperatively. Age of ≥4 years and cardiopulmonary bypass (CPB) time ≥51 min were identified as independent risk predictors for POV and the AUC of logistic regression model was 0.650 (95% confidence interval; 0.565-0.735).



The incidence of POV in children undergoing surgical ASD repair was 37.5%. Age ≥4 years and CPB time ≥51 min were identified as independent predictors.
Department of Anesthesiology, Perioperative and Pain Medicine, Cardiac Anesthesia Division, Boston Children's Hospital, Boston, MA, USA.
Joshua
J
Lee
Department of Anesthesiology, Perioperative and Pain Medicine, Cardiac Anesthesia Division, Boston Children's Hospital, Boston, MA, USA.
David
D
Faraoni
Department of Anesthesiology, Perioperative and Pain Medicine, Cardiac Anesthesia Division, Boston Children's Hospital, Boston, MA, USA.
Sandra
S
Lee
Department of Anesthesiology, Perioperative and Pain Medicine, Cardiac Anesthesia Division, Boston Children's Hospital, Boston, MA, USA.
Morgan
M
Brown
Department of Anesthesiology, Perioperative and Pain Medicine, Cardiac Anesthesia Division, Boston Children's Hospital, Boston, MA, USA.
Kirsten
K
Odegard
Department of Anesthesiology, Perioperative and Pain Medicine, Critical Care Division, Boston Children's Hospital, Boston, MA, USA.
Adrienne
A
Randolph
Department of Anesthesiology, Perioperative and Pain Medicine, Cardiac Anesthesia Division, Boston Children's Hospital, Boston, MA, USA.
James A
JA
DiNardo
Department of Anesthesiology, Perioperative and Pain Medicine, Cardiac Anesthesia Division, Boston Children's Hospital, Boston, MA, USA.
Koichi
K
Yuki
D000367:Age Factors; D000758:Anesthesia / Q000379:methods*; D000932:Antiemetics / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D061646:Operative Time; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors
D000932:Antiemetics
cardiac surgery; cardiopulmonary bypass; fast-track; pediatric; postoperative vomiting; risk factor