Introduction Despite recent advances in anaesthesia, cardiopulmonary bypass and surgical techniques, children undergoing congenital heart surgery require postoperative mechanical ventilation. Early extubation was defined as ventilation shorter than 12 h.
Aim To identify markers associated with successful early extubation after paediatric cardiac surgery.
Methods Retrospective-prospective clinical study was performed in Paediatric Clinic and Heart Centre Clinical Centre Univerity of Sarajevo during period from 01.01.2006. till 01.01.2011. Study included 100 children up to 5 years of age with congenital heart disease with left–right shunt and opstructive congenital heart disease, Patients were devided into two groups: I Group-54 patients extubated within 12 h after surgery and Group II- 46 patients extubated more then 12 h after surgery.
Results The most frequently encountered preopeartive variables were age with odds ratio 4% 95% CI(1–7%), Down’s syndrome 8,5 95% CI (1,6–43,15), failure to thrive 4,3 95% CI(1–18). Statisticly significant postoperative data included lung disease (reactive airways, pneumonia, atelectasis, pneumothorax) and with odds ratio 35,1 95% CI (4–286) and blood transfusion with odds ratio 4,6 95% CI(2–12). Proven markers were age with cut of 21,5 months (sensitivity 74% and specificity 70%) and extracorporeal circulation (ECC) with cut of 45,5 min (sensitivity 71% and specificity 65%).
Conclusion Younger age and prolonged time ECC are markers associated with prolonged mechanical ventilation.
- early extubation
- congenital heart surgery
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