Predictors of Intensive Care Unit Morbidity and Midterm Follow-up after Primary Repair of Tetralogy of Fallot

Egbe, Alexander C.; Nguyen, Khanh; Mittnacht, Alexander J.C.; Joashi, Umesh

doi:10.5090/kjtcs.2014.47.3.211

Cited by 11 publications

(5 citation statements)

References 20 publications

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“…Furthermore, the higher right ventricle load results in more severe right ventricle pachynsis, which may lead to a higher right atrium/superior vena cava pressure and play a critical role in postoperative complications ( Figure 4 ). In our study, body weight at surgery was associated with PHS, CICU stay, and ventilator time ( Table 4 ), which is similar to the results reported by some groups ( 30 , 31 ) but different from those reported by Mercer-Rosa et al ( 17 ). This may be because we had a more significant variation in age and body weight in our cohort, which is a common situation in most developing countries.…”

Section: Discussionsupporting

confidence: 83%

Pulmonary Vein Index Is Associated With Early Prognosis of Surgical Treatment for Tetralogy of Fallot

et al. 2021

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Objectives: To evaluate the predictive value of the pulmonary vein index (PVI) in the early prognosis of patients who received total tetralogy of Fallot (TOF) repair.Methods: We retrospectively reviewed 286 patients who underwent TOF repair in our institution between July 2013 and May 2020. The PVI, McGoon ratio, and Nakata index were measured and calculated. Logistic regression, linear stepwise regression, receiver operating characteristic (ROC) curve analysis, and Cox proportional hazards modeling were performed to evaluate the predictive value of PVI in the early prognosis after TOF repair surgery.Results: The median age and body weight were 1.23 (0.22–15.02) years and 9.00 (3.00–44.00) kg, respectively. There were five early deaths. The areas under the ROC curve for death were 0.89, 0.79, and 0.88 for the McGoon ratio, Nakata index, and PVI, respectively. A lower PVI better predicted prolonged postoperative hospital stay, cardiac intensive care unit stay, and ventilator time (Hazard Ratio, HR [95% Confidence intervals, CI]: 1.003 [1.002–1.004], p < 0.001; 1.002 [1.001–1.004], p < 0.001; 1.002 [1.001–1.003], p < 0.001, respectively) and was a significant risk factor for high 24 h max Vasoactive inotropic score (Crude Odds Ratio [OR] [95% CI]: −0.015 [−0.022, −0.007], p < 0.001), serous effusion (Crude OR [95% CI]: 0.996 [0.992–0.999], p = 0.020), delayed sternal closure (Crude OR [95% CI]: 0.983 [0.971–0.996], p = 0.010), and the need for peritoneal dialysis (Crude OR [95% CI]: 0.988 [0.980–0.996], p = 0.005). The area under the ROC curve of PVI for delayed postoperative recovery was 0.722 (p < 0.001), and the estimated cutoff point was 300.3 mm2/m2.Conclusion: PVI is a good predictor of early prognosis for surgical treatment of TOF patients.

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Section: Discussionsupporting

confidence: 83%

Pulmonary Vein Index Is Associated With Early Prognosis of Surgical Treatment for Tetralogy of Fallot

et al. 2021

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“…The duration of mechanical ventilation (MV) is one of the most important clinical factors which predicts outcomes in pediatric cardiac surgery (1-13). The improvement in MV protocols and early extubation shortens the intensive care unit (ICU) stay and results in less complications and improved outcomes (14-16) .Hence, there is a need to identify and quantify clinical predictors of prolonged mechanical ventilation (PMV).Predictors of PMV after pediatric cardiac surgery are investigated in several studies (1-13). Parameters such as the clinical condition of the patients and underlying disorders, factors related to surgical and anesthetic techniques, the postoperative ICU management protocols and certain postoperative complications including renal failure can influence the length of intubation (1-13).…”

Section: Introductionmentioning

confidence: 99%

Predictors of prolonged mechanical ventilation in pediatric patients after cardiac surgery for congenital heart disease

Tabib¹,

Abrishami²,

Mahdavi³

et al. 2016

Res Cardiovasc Med

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BackgroundThe duration of mechanical ventilation (MV) is one of the most important clinical factors which predict outcomes in pediatric cardiac surgery. The prolonged mechanical ventilation (PMV) following cardiac surgery is a multifactorial phenomenon and there are conflicts regarding its predictors in pediatric population between different centers.ObjectivesThe current study aimed to describe PMV predictors in patients undergoing cardiac surgery for congenital heart disease in a tertiary center for pediatric cardiovascular diseases in Iran.Patients and MethodsFrom May to December 2014, all pediatric patients (less than a month – 15 years old) admitted to pediatric Intensive Care Unit (PICU) after congenital heart surgeries were consecutively included. The PMV was defined as mechanical ventilation duration more than 72 hours as medium PMV and more than seven days as extended PMV. The demographic data and variables probably related to PMV were recorded during the PICU stay.ResultsA total of 300 patients, 56.7% male, were enrolled in this study. Their mean age was 32 ± 40 months .The median duration (IQR) of MV was 18 hours (8.6 - 48 hours). The incidence of PMV more than 72 hours and seven days was 20% and 10.7%, respectively. Younger age, lower weight, heart failure, higher doses of inotropes, pulmonary hypertension, respiratory infections and delayed sternal closure were independent predictors of PMV in multivariate analyses.ConclusionsThe results of this study indicated that PMV predictors could be specific for each center and a good administration program is needed for each pediatric cardiac surgery center for the preoperative management of patients undergoing congenital heart surgeries.

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“…Tracheostomy is usually performed in children undergoing high-risk complex surgical procedures, and postsurgery cardiac complications, such as severe ventricular dysfunction, low cardiac output, residual lesions, sepsis, syndromic association, airway issues, etc. [1][2][3][4].…”

Section: Introductionmentioning

confidence: 99%

“…This means that tracheostomy has to be viewed as a complication and measures for reducing the duration of tracheostomy should be taken. Predictors of PMV after pediatric cardiac surgery are investigated in several studies [1][2][3][4]. However, there is a dearth of literature describing the predictors and associations of prolonged duration tracheostomy among pediatric cardiac surgical patients.…”

Section: Introductionmentioning

confidence: 99%

Predictors and Associations of Prolonged Tracheostomy in Pediatric Cardiac Surgical Patients

Bipin,

Sahu,

Singh

et al. 2024

Int J Anaesth Crit Care

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Objectives: To describe the predictors and associations of prolonged tracheostomy duration in pediatric cardiac surgical patients. Method: Prospective study. All pediatric patients below 10 years of age who underwent tracheostomy after cardiac surgery from January 2019 to December 2019, were subdivided into short and long groups according to the tracheostomy duration during the intrahospital stay if more than 21 days. Different variables were compared. Results:1084 pediatric patients who underwent cardiac surgery during study period, 41 (3.7%) received tracheostomy. LT group was associated with univentricular repair (p=0.03) and sepsis (p=0.04), longer days of ventilation (p=0.0005), higher number of extubation trials (p=0.02), higher accidental tracheostomy tube dislodgement (p=0.048), ventilator-associated pneumonia (p=0.013), more days of feed interruption (p=0.0089), higher days of hospital stay (p=0.0001) and intensive care unit stay (p=0.0001). ST was associated with significantly higher anticipated longer duration of ventilation and earlier liberation from the ventilator as an indication for tracheostomy than LT (p=0.02). Conclusions: Univentricular repair, sepsis, longer mechanical ventilation, longer duration of intensive care unit and hospital stay, a higher number of extubation trials, higher number of accidental tracheostomy tube dislodgement, ventilator-associated pneumonia, higher days of feed interruption were found to be significant associations with a long duration tracheostomy.

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Predictors of Intensive Care Unit Morbidity and Midterm Follow-up after Primary Repair of Tetralogy of Fallot

Cited by 11 publications

References 20 publications

Pulmonary Vein Index Is Associated With Early Prognosis of Surgical Treatment for Tetralogy of Fallot

Pulmonary Vein Index Is Associated With Early Prognosis of Surgical Treatment for Tetralogy of Fallot

Predictors of prolonged mechanical ventilation in pediatric patients after cardiac surgery for congenital heart disease

Predictors and Associations of Prolonged Tracheostomy in Pediatric Cardiac Surgical Patients

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