Immediate post-operative care following cardiac surgery

João, Paulo Ramos David; Faria, Fernando

doi:10.2223/jped.1098

Cited by 11 publications

(19 citation statements)

References 27 publications

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“…Improvement of paediatric intensive care unit (PICU) facilities have increased the survival rates in complicated paediatric cardiac surgery. 1 Assistant Professor. Dept.…”

Section: Introductionmentioning

confidence: 99%

Early Postoperative Arrhythmias after Paediatric Cardiac Surgery

et al. 2018

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Background: The radical change in techniques in paediatric cardiac surgery has dramatically reduced the morbidity and mortality. The different varieties of arrhythmia that are frequently observed in postoperative period in our country are still not well documented.Objectives: To determine the incidence and risk factors of arrhythmia immediately after cardiac surgery in paediatric age group.Materials and method: It was a prospective study. A total of 100 paediatric patients (age <18 years) who underwent cardiac surgery at Dhaka Shishu Hospital between 2013 and 2016 were selected purposivelyResults: Out of 100 patients maximum 41% were from 13-72 months age group. The mean age was 49.73±37.17 months with range of 0.5-231 months, 58% patients were male and rest were female. Postoperatively 31% subjects were arrhythmic and of these the highest number of patients suffered from junctional ectopic tachycardia. Out of these 100 patients, 39% were diagnosed as VSD followed by TOF (35%). Among 31 arrhythmic patients 59.83%, 41.93% and 3.22% manifested onset of arrhythmia at 1st, 1st to 2nd and 2nd to 7th postoperative period respectively. In this study age, body weight, cyanosis, CPB time, postoperative acidosis, ventilation support days, hypertension on arrival in ICU as well as ICU stay days were recognized as significant risk factors (p <0.05).Conclusion: Proper and careful monitoring of younger patient with lower body weight undergoing corrective cardiac surgery with long cardiopulmonary bypass (CPB) time may reduce the episodes of post operative arrhythmia. These patients may require high inotropic support post operatively. So, medical prevention and early diagnosis as well as proper management may improve the operative outcome.Delta Med Col J. Jan 2018 6(1): 22-28

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“…Improvement of paediatric intensive care unit (PICU) facilities have increased the survival rates in complicated paediatric cardiac surgery. 1 Assistant Professor. Dept.…”

Section: Introductionmentioning

confidence: 99%

Early Postoperative Arrhythmias after Paediatric Cardiac Surgery

et al. 2018

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“…Because of the high incidence of respiratory complications, physical therapy, which should be initiated on the first day after arrival in the PICU, contributes to adequate ventilation and the success of extubation (7) and reduces hospitalization time and PICU stay (12,13) . In this study, this therapy was used in 72% of the patients and may have affected the onset, or not, of respiratory complications postoperatively.…”

Section: Discussionmentioning

confidence: 99%

Perfil das crianças submetidas à correção de cardiopatia congênita e análise das complicações respiratórias

Oliveira

Held

Grande

et al. 2012

Rev. paul. pediatr.

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6Doutora em Saúde da Criança e do Adolescente pela Unicamp, Campinas, SP, Brasil; Professora efetiva do curso de graduação e pós-graduação em Fisioterapia da Udesc, Florianópolis, SC, Brasil ABSTRACTObjective: To describe the profile of children that undergo surgical correction of congenital heart disease (CHD) in a university hospital and to compare patients with and without postoperative respiratory complications.Method: This observational analytical study reviewed the records of children that underwent corrective surgery for CHD a Brazilian University Hospital during 11 months. The following demographic variables were collected: age, sex, body mass index, comorbidities, and CHD types. Demographic variables and data about the intra-and postoperative care were compared for patients with and without postoperative respiratory complications. The Mann-Whitney and the Fisher exact tests were used, and the level of significance was set at p<0.05.Results: The sample consisted of 55 children (49% boys) whose median age was 37.5 months. Three or more CHD were found in 29.1%, and 53% of all cases had comorbidities. The analysis of postoperative respiratory complications revealed that 31% of the patients had atelectasis and pleural effusion and 5.5% had laryngitis, pneumomediastinum or lung injury. Non-respiratory complications were identified in 24% of the patients. Survival was 89%. Children with postoperative respiratory complications received mechanical ventilation for a longer time and had a prolonged hospital stay (p<0.001). Conclusion:The association between respiratory complications, longer mechanical ventilation and longer hospital stay reinforced the need to avoid such complications to reduce costs of a prolonged hospital stay.Key-words: heart defects, congenital; thoracic surgery; clinical evolution; intensive care units; pediatrics. Resultados: Foram analisados 55 (95%) prontuários disponíveis de crianças submetidas à cirurgia cardíaca com mediana de idade de 37,5 meses, sendo 49% meninos. Presença de três ou mais CC foi verificada em 29,1% dos pacientes e 53% dos casos apresentavam comorbidades. Quanto às complicações respiratórias no pós-operatório, 31% dos pacientes evoluíram com atelectasia/derrame pleural e 5,5% laringite/pneumomediastino/lesão pulmonar. Complicações em outros sistemas foram identificadas em 24% dos pacientes. A sobrevida foi de 89% e crianças com complicações respiratórias no pós-operatório foram submetidas a maior tempo de ventilação mecânica e permanência hospitalar (p<0,001).Conclusões: O conhecimento da relação entre complicações respiratórias e maior tempo de ventilação mecânica e hospitalização reforça a necessidade de prevenir tais complicações para redução dos custos hospitalares.Palavras-chave: cardiopatias congênitas; cirurgia torácica; evolução clínica; unidade de terapia intensiva; pediatria. RESUMENObjetivo: Describir las características demográficas y clínicas de niños sometidos a la cirugía de corrección de cardiopatía congénita (CC) en un hospital universitario, comparand...

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“…When the sample of expiratory gas is collected near the continuous flow of oxygen, a CO 2 dilution can occur, and the values of PETCO 2 will be erroneous. 24 According to Lightdale et al 19 and Takano et al, 25 compared with the mainstream technology, microstream capnography has less potential for inaccurate measurements from oxygen interference because the microstream method is highly selective for CO 2 . In an investigation of 80 CO 2 measurements…”

Section: Discussionmentioning

confidence: 99%

“…End tidal carbon dioxide (PETCO 2) , an indirect and noninvasive measure of blood carbon dioxide tensions, responds quickly to changes in carbon dioxide levels.…”

Section: Methodsmentioning

confidence: 99%

Measurement of End-Tidal Carbon Dioxide in Spontaneously Breathing Children After Cardiac Surgery

Rasera

Gewehr

Domingues

et al. 2011

American Journal of Critical Care

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BackgroundRespiratory monitoring is important after surgery to prevent pulmonary complications. End-tidal carbon dioxide (Petco2) measurement by capnometry is an indirect and noninvasive measurement of Pco2 in blood and is accepted and recognized in critical care.ObjectivesTo determine the correlation and level of agreement between Petco2 and Paco2 in spontaneously breathing children after cardiac surgery and to determine whether Petco2 measured by using tidal volume (Vt-Petco2) or vital capacity (VC-Petco2) shows more or less significant correlation with Paco2.MethodsVt-Petco2 and VC-Petco2 by capnometry and Paco2 by blood gas analysis were measured once a day after tracheal extubation. The determination coefficient and degree of bias between the methods were assessed in children with and without supplemental oxygen.ResultsA total of 172 Vt-Petco2, VC-Petco2, and Paco2 values from 48 children were analyzed. The overall coefficients of determination were 0.84 (P < .001) for Vt-Petco2 and Paco2 and 0.62 (P = .02) for VC-Petco2 and Paco2. The mean gradient for Paco2 to Petco2 in all groups increased with the increase in supplemental oxygen; the gradient was significantly larger in the groups given 2 to 5 L of oxygen per minute.ConclusionsIn spontaneously breathing children, Vt-Petco2 provided a more accurate estimate of Paco2 than did VC-Petco2, especially in children given little or no supplemental oxygen. The difference between the methods was significantly larger in the groups given 2 to 5 L of oxygen per minute.

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Immediate post-operative care following cardiac surgery

Cited by 11 publications

References 27 publications

Early Postoperative Arrhythmias after Paediatric Cardiac Surgery

Early Postoperative Arrhythmias after Paediatric Cardiac Surgery

Perfil das crianças submetidas à correção de cardiopatia congênita e análise das complicações respiratórias

Measurement of End-Tidal Carbon Dioxide in Spontaneously Breathing Children After Cardiac Surgery

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