On-table extubation after open heart surgery in children: an experience from a tertiary care hospital in a developing country.

Document Type

Article

Department

Cardiothoracic Surgery

Abstract

Abstract

BACKGROUND:

Recent advances in various disciplines of medicine have significantly changed the courses following cardiac surgery in children. On-table extubation (OTE) after open heart surgery in children is evolving.

OBJECTIVE:

To assess the rate of postoperative complications in children extubated on table after open heart surgery.

DESIGN:

This is a retrospective, descriptive study.

SETTING:

Operating room (OR) then admitted to the pediatric intensive care unit (PICU).

PATIENTS:

All pediatric patients (between 0 and 18 years) undergoing open heart surgery between January 2011 and June 2013.

INTERVENTION:

On-table extubation.

OUTCOME MEASURES:

Rates of immediate postoperative complications, i.e., re-intubation, significant bleeding, low cardiac output syndrome, and arrhythmia in PICU, were assessed. Data are presented as frequencies and mean ± standard deviation.

RESULTS:

A total of 82 patients were included. Mean age at time of operation was 7.25 ± 6.6 years. Fifty-three percent (n = 44) were <5 years old and 64% (n = 53) were men. Ventricular septal defect (47%, n = 39) was the most common lesion, followed by atrial septal defect (36%, n = 30), and tetralogy of Fallot (15%, n = 12), which were repaired. Cardiopulmonary bypass and aortic cross clamp time were 72.3 ± 34.2 and 47.3 ± 27.8 minutes, respectively. The mean inotrope score was 2.66 ± 3.53. There was no mortality in the cohort, whereas 97.8% (n = 80) had no complications during PICU stay. One patient (1.1%) required re-intubation for respiratory failure and one patient (1.1%) had arrhythmia that was medically managed. The mean length of PICU stay was 1.77 ± 0.985 days.

CONCLUSION:

On-table extubation in children after open heart surgery was feasible and safe in selected group of patients. There was no major complication observed in the PICU.

Publication (Name of Journal)

Congenit Heart Dis

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