Functional deficit in children with congenital heart disease undergoing surgical correction after intensive care unit discharge

Abstract

Objective To evaluate the functional status of pediatric patients undergoing congenital heart surgery after discharge from the intensive care unit, and to evaluate the correlations among clinical variables, functional status and surgical risk. Methods Cross-sectional study including patients aged 1 month to less than 18 years undergoing congenital heart surgery between October 2017 and May 2018. Functional outcome was assessed by the Functional Status Scale, surgical risk classification was determined using the Risk Adjustment for Congenital Heart Surgery-1 (RACHS-1), and clinical variables were collected from electronic medical records. Results The sample comprised 57 patients with a median age of 7 months (2 - 17); 54.4% were male, and 75.5% showed dysfunction, which was moderate in 45.6% of the cases. RACHS-1 category > 3 was observed in 47% of the sample, indicating higher surgical risk. There was a correlation between functional deficit and younger age, longer duration of invasive mechanical ventilation and longer intensive care unit stay. Moreover, greater functional deficit was observed among patients classified as RACHS-1 category > 3. Conclusion The prevalence of functional deficit was high among children and adolescents with congenital heart disease after cardiac surgery. Higher surgical risk, longer duration of invasive mechanical ventilation, longer intensive care unit stay and younger age were correlated with worse functional status.

Habilitation of Executive Functions in Pediatric Congenital Heart Disease Patients through LEGO®-Based Therapy: A Quasi-Experimental Study

“…In this research, we evaluated the cognitive deficit presented by patients with congenital heart disease after undergoing cardiovascular surgery and the effect of therapy based on LEGO ® Education on frontal executive functions. In the pretest measurement, more than 50% of the participants showed cognitive impairment, either severe or mild to moderate, which corresponds to what is stated in the literature regarding cognitive impairment in patients with congenital heart disease [ 12 , 13 ].…”

“…Cardiovascular surgeries can be stratified through the Risk Adjusted Classification for Congenital Heart Surgery (RACHS-1), which considers the complexity level at the congenital malformation and the surgery risk, among other factors [ 11 ]. It has been reported that a higher level on the RACHS-1 scale (from 3 to 6) may result in a higher detriment at a cognitive level in these patients [ 12 , 13 ].…”