Pulmonary risk factors compromising postoperative recovery after surgical repair for congenital heart disease
Pulmonary risk factors compromising postoperative recovery after surgical repair for congenital heart disease
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DOI：
10.1378/chest.116.3.740
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发表时间：
1999-09-01
期刊：
影响因子：
9.6
通讯作者：
Gozal, D
中科院分区：
文献类型：
--
作者：
Bandla, HPR;Hopkins, RL;Gozal, D
目的：确定与幼儿长期入住ICU相关的肺部危险因素（小于或等于2年）接受先天性心脏病（CHD）手术I修复术，设计：回顾性病例系列分析。回顾了134例连续的、年龄小于或等于2岁的因冠心病接受心脏手术的患者的临床记录，根据纳入标准排除37例。因此，97名患者根据ICU停留时间被分配到两组：小于或等于7天（第1组，n = 57），且> 7天（第2组，n = 40），结果：第1组和第2组的平均ICU持续时间分别为3.0 ± 0.4天和28.1 ± 4.4天第1组有3例拔管失败，第2组有11例拔管失败（p <0.0001），共22例患者第1组4例和第2组18例发生非感染性肺部并发症，如气道问题，包括外源性气道压迫和气管支气管炎（n = 6）;肺动脉高压（n = 5）;膈神经麻痹（n = 7）;胸腔积液（n = 8）。这22例患者（23%）占总呼吸机天数（67%）和ICU住院天数（61%）的大部分。一般来说，肺部并发症，特别是中心气道问题，是幼儿心脏手术后延迟恢复的常见原因。
objectives: To identify pulmonary risk factors associated with prolonged ICU stay in young children (less than or equal to 2 years) undergoing surgical I repair for congenital heart disease (CHD),Design: Retrospective case series analysis.Setting: Tertialy-care facility,Patients: Clinical records of 134 consecutive, patients aged less than or equal to 2 years undergoing cardiac surgery for CHD were reviewed, and 37 were excluded according to inclusion criteria. Thus, 97 patients were allocated to two groups based on the duration of ICU stay: less than or equal to 7 dais (group 1, n = 57), and > 7 days (group 2, n = 40),Results: Mean ICU duration for groups 1 and 2 was 3.0 +/- 0.4 days and 28.1 +/- 4.4 days, respectively (p < 0,001), In group 1, there were three extubation failures, whereas 11 extubation failures occurred in group 2 (p < 0,0.0001), A total of 22 patients (4 in group 1 and 18 in gl group 2) developed noninfectious pulmonary complications, such as airway, problems, including extrinsic airway compression and tracheobronchomal, (n = 6); pulmonary hypertension (n = 5); phrenic nerve palsy (n = 7); and pleural effusion (n = 8), These 22 patients (23%) contributed to the majority of total ventilator days (67%) as well as ICU stay (61%).Conclusions: Pulmonary complications in general, and central airway problems in particular, are a frequent cause for delayed recovery following cardiac surgery in young children.