Association between preoperative respiratory support and outcomes in paediatric cardiac surgery

Ciociola, Elizabeth C.; Kumar, Karan; Zimmerman, Kanecia O.; Thompson, Elizabeth J.; Harward, Melissa; Sullivan, Laura N.; Turek, Joseph W.; Hornik, Christoph P.

doi:10.1017/s1047951119002786

Cited by 7 publications

(3 citation statements)

References 26 publications

(35 reference statements)

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“…Other studies, however, have failed to demonstrate the association of preoperative MV and extubation failure in broader populations (10, 18, 23, 24). Previous studies have demonstrated the association of preoperative NIV or MV with longer postoperative length of stay (25) and mortality (25–27). None of these studies evaluated for an association with extubation failure.…”

Section: Discussionmentioning

confidence: 99%

Associations With Extubation Failure and Predictive Value of Risk Analytics Algorithms With Extubation Readiness Tests Following Congenital Cardiac Surgery

Hames

Sleeper

Bullock

et al. 2022

Pediatric Critical Care Medicine

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Extubation failure is associated with morbidity and mortality in children following cardiac surgery. Current extubation readiness tests (ERT) do not consider the nonrespiratory support provided by mechanical ventilation (MV) for children with congenital heart disease. We aimed to identify factors associated with extubation failure in children following cardiac surgery and assess the performance of two risk analytics algorithms for patients undergoing an ERT. DESIGN: Retrospective cohort study.SETTING: CICU at a tertiary-care children's hospital.

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Section: Discussionmentioning

confidence: 99%

Associations With Extubation Failure and Predictive Value of Risk Analytics Algorithms With Extubation Readiness Tests Following Congenital Cardiac Surgery

Hames

Sleeper

Bullock

et al. 2022

Pediatric Critical Care Medicine

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“…Preoperative mechanical ventilation is a known predictor of adverse outcomes following paediatric cardiac surgery. 17 In an analysis of 25,476 paediatric congenital heart surgeries, Jacobs et al found that discharge mortality was significantly higher in patients who were mechanically ventilated preoperatively compared to overall mortality for neonates (15.1% versus 9.88%), infants (11.5% versus 2.91%) and children (14.4% versus 0.92%; P <0.001). 18 Similar observations have been described post-mBT shunt surgery.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Infants Undergoing Modified Blalock-Taussig Shunt Procedures in Oman

Shaikh

Al-Mukhaini

Alrawahi

et al. 2021

Sultan Qaboos Univ Med J

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Objectives: A modified Blalock-Taussig (mBT) shunt procedure is a common palliative surgery used to treat infants and children with cyanotic congenital heart disease (CCHD). This study aimed to report the outcomes of infants and children undergoing mBT shunt procedures in Oman. In addition, risk factors associated with early mortality, inter-stage mortality and reintervention were assessed. Methods: This retrospective cohort study was conducted from January 2016 to December 2018 at the National Heart Centre, Muscat, Oman. All paediatric patients with CCHD undergoing mBT shunt procedures as a primary palliative procedure during this period were included. Data were retrieved from electronic hospital records. Kaplan-Meier survival curves were used to describe overall survival. Results: A total of 50 infants and children were included in the study. The in-hospital mortality and inter-stage mortality rates were 10% and 6.7%, respectively. Preoperative mechanical ventilation (odds ratio [OR]: 3.00, 95% confidence interval [CI]: 1.98–4.76; P = 0.007) and cardiopulmonary bypass (OR: 4.09, 95% CI: 2.44–6.85; P = 0.002) were significant risk factors for early mortality. In-hospital and interval surgical reintervention rates were 12% and 13.3%, respectively. Following the primary shunt procedure, the median time to second-stage surgery was 15.5 months (range: 5.0–34.0 months). Conclusion: The findings of this study support those reported in international research regarding the risks associated with mBT shunt surgeries. In particular, preoperative mechanical ventilation and cardiopulmonary bypass were significant risk factors for early mortality. Keywords: Pediatrics; Heart Diseases, congenital; Cardiovascular Surgical Procedures; Modified Blalock-Taussig Procedure; Patient Outcome Assessment; Hospital Mortality; Risk Factors; Oman.

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“…З усіх цих причин рекомендується раннє відлучення від апарату ШВЛ. Більшість маленьких пацієнтів можна відлучити вже через 6-24 години після кардіохірургічної операції, але деякі пацієнти потребують тривалої ШВЛ (понад 24 години) через ускладнення з боку дихальної системи, зниження серцевої функції або інфекції тощо [6].…”

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Analysis of the Use of Non-Invasive Lung Ventilation Support in Newborns and Young Children after Cardiac Surgery

Yakimishen,

Tsymbal,

Boiko

et al. 2023

ujcvs

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Background. Non-invasive ventilatory support for artificial lung ventilation (ALV) in infants with congenital heart disease after cardiac surgery helps to reduce the duration of invasive ALV, reduce the number of mechanical and infectious complications, and reduce or eliminate the need for sedation. The aim. To analyze the experience of using non-invasive ventilatory support after surgical correction of congenital heart disease in infants and compare its effectiveness with invasive mechanical ventilation. Materials and methods. We conducted a retrospective analysis of the use of non-invasive ALV and its effectiveness compared to invasive mechanical ventilation in children under 1 year of age after cardiac surgery from 2020 to 2022 at the Department of Cardiac Arrest in Newborns and Young Children of the National Amosov Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine. During this period, 134 patients were operated on (38 children under 1 month old, 96 children under 1 year old). In the postoperative period, 85 children (55.9%) needed prolonged mechanical ventilation (more than 24 hours), of which non-invasive ventilation support was used in 32 patients (37.6%) and invasive ventilation in 53 (62.3%) patients. Results. The patients on non-invasive ALV (n = 32) had lower weight (p = 0.23), shorter ventilation time (p = 0.56), and the time spent at the intensive care unit (p = 0.61), required less sedation (p = 0.29), and had lower mortality (p = 0.42) compared to the group of children who received only invasive ventilatory support (n = 53), but this difference was not statistically significant. The need for non-invasive ventilation was higher in 9 (28.12%) infants than in 8 (15.09%) other infants and was statistically significant (p < 0.001). Conclusions. Our study showed that the use of non-invasive ALV can shorten the length of stay at the intensive care unit and the time spent on ventilation, reduce or avoid the use of sedation, and prevent pulmonary complications (infectious and mechanical) with long-term treatment. However, there was no significant difference between non-invasive and invasive ventilation in terms of mortality.

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Association between preoperative respiratory support and outcomes in paediatric cardiac surgery

Cited by 7 publications

References 26 publications

Associations With Extubation Failure and Predictive Value of Risk Analytics Algorithms With Extubation Readiness Tests Following Congenital Cardiac Surgery

Associations With Extubation Failure and Predictive Value of Risk Analytics Algorithms With Extubation Readiness Tests Following Congenital Cardiac Surgery

Outcomes of Infants Undergoing Modified Blalock-Taussig Shunt Procedures in Oman

Analysis of the Use of Non-Invasive Lung Ventilation Support in Newborns and Young Children after Cardiac Surgery

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