Risk factors for prolonged ventilation after the modified Fontan procedure
| Autor: | Kensaku Motono, Masahiro Tsubura, Nao Hamamoto, Masaki Osaki |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Heart Defects
Congenital medicine.medical_treatment Airway Extubation Fontan Procedure Hypoplastic left heart syndrome Fontan procedure Risk Factors medicine.artery Extracorporeal membrane oxygenation Humans Medicine Intubation Child Retrospective Studies Mechanical ventilation business.industry General Medicine Perioperative medicine.disease Respiration Artificial Treatment Outcome Anesthesia Pediatrics Perinatology and Child Health Pulmonary artery Cardiology and Cardiovascular Medicine business |
| Zdroj: | Cardiology in the Young. 32:969-974 |
| ISSN: | 1467-1107 1047-9511 |
| DOI: | 10.1017/s1047951121003498 |
| Popis: | Objective:To investigate the risk factors associated with prolonged ventilation after Fontan surgery.Design:Retrospective case series.Setting:Tertiary childrens hospital.Patients:We included 123 children who underwent Fontan surgery without delayed sternal closure or extracorporeal membrane oxygenation between 2011 and 2017.Intervention:Fontan surgery.Measurements and main results:Prolonged ventilation was defined as intubation for more than 24 hours after surgery. Preoperative, intraoperative, and perioperative data were collected retrospectively from medical records. Multivariate logistic regression analysis was used to identify risk factors for prolonged ventilation. The median age and weight of patients were 2.2 years and 10.0 kg, respectively. Seventeen per cent of the patients (n = 21) received prolonged mechanical ventilation, and the median intubation period was 2.9 days. There were no 90-day or in-hospital deaths. The independent predictors of prolonged ventilation identified were fenestration (p < 0.01), low pulmonary artery index (p = 0.02), and advanced atrioventricular regurgitation (p < 0.01). The duration of ICU stay was significantly longer in the prolonged ventilation group than in the early extubation group (10 days versus 6 days, p < 0.01).Conclusion:Fenestration, low pulmonary artery index, and significant atrioventricular regurgitation are risk factors for prolonged ventilation after Fontan surgery. Careful preoperative and perioperative management that considers the risk factors for prolonged ventilation in each individual is important. |
| Databáze: | OpenAIRE |
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