Postoperative mechanical ventilation after corrective Tetralogy of Fallot surgery in infants: Assessment of perioperative factors and radiographic severity scores

Q2 Nursing

Perioperative Care and Operating Room Management Pub Date : 2024-11-16 DOI:10.1016/j.pcorm.2024.100446

Panop Limratana , Wiriya Maisat , Lee Ferguson , Christopher W. Baird , Koichi Yuki

{"title":"Postoperative mechanical ventilation after corrective Tetralogy of Fallot surgery in infants: Assessment of perioperative factors and radiographic severity scores","authors":"Panop Limratana , Wiriya Maisat , Lee Ferguson , Christopher W. Baird , Koichi Yuki","doi":"10.1016/j.pcorm.2024.100446","DOIUrl":null,"url":null,"abstract":"<div><div>Early recovery from surgery for congenital heart disease (CHD) is becoming a trend. Tetralogy of Fallot/pulmonary stenosis (TOF/PS) is the most common cyanotic CHD with excellent long-term outcomes. We examined potential factors associated with early extubation in 249 patients who underwent TOF/PS complete repair in a tertiary pediatric medical center from January 2015 to December 2022. Patient demographics, preoperative characteristics, intraoperative variables, postoperative outcomes, surgical type, surgical duration, cardiopulmonary bypass (CPB) time, cross-clamp time, and blood product volumes were acquired from the electronic medical records. Valve sparing repair (VSR) tends to demonstrate earlier recovery profiles than transannular patch repair (TAP) irrelevant of the presence of monocusp valve (<em>P</em> < 0.0001) and the degree of right ventricular outflow pressure drop was significantly correlated with post-operative recovery profile (<em>p</em> = 0.0204). Because of intracardiac shunts and PaO<sub>2</sub>/FiO<sub>2</sub> ratios being poor indicators of lung injury, Brixia scores were also used. Our data suggested that Brixia score could be an excellent alternative to evaluate post-operative lung status.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"37 ","pages":"Article 100446"},"PeriodicalIF":0.0000,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Perioperative Care and Operating Room Management","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2405603024000797","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Nursing","Score":null,"Total":0}

引用次数: 0

Abstract

Early recovery from surgery for congenital heart disease (CHD) is becoming a trend. Tetralogy of Fallot/pulmonary stenosis (TOF/PS) is the most common cyanotic CHD with excellent long-term outcomes. We examined potential factors associated with early extubation in 249 patients who underwent TOF/PS complete repair in a tertiary pediatric medical center from January 2015 to December 2022. Patient demographics, preoperative characteristics, intraoperative variables, postoperative outcomes, surgical type, surgical duration, cardiopulmonary bypass (CPB) time, cross-clamp time, and blood product volumes were acquired from the electronic medical records. Valve sparing repair (VSR) tends to demonstrate earlier recovery profiles than transannular patch repair (TAP) irrelevant of the presence of monocusp valve (P < 0.0001) and the degree of right ventricular outflow pressure drop was significantly correlated with post-operative recovery profile (p = 0.0204). Because of intracardiac shunts and PaO₂/FiO₂ ratios being poor indicators of lung injury, Brixia scores were also used. Our data suggested that Brixia score could be an excellent alternative to evaluate post-operative lung status.

查看原文本刊更多论文

婴儿法洛氏四联症矫正手术后的术后机械通气：围手术期因素和放射学严重程度评分评估

先天性心脏病（CHD）手术后早期康复已成为一种趋势。法洛氏四联症/肺动脉狭窄（TOF/PS）是最常见的紫绀型先天性心脏病，长期疗效极佳。我们研究了2015年1月至2022年12月在一家三级儿科医疗中心接受TOF/PS完全修复术的249名患者中与早期拔管相关的潜在因素。我们从电子病历中获取了患者的人口统计学特征、术前特征、术中变量、术后结果、手术类型、手术持续时间、心肺旁路（CPB）时间、交叉钳夹时间和血液制品量。与单瓣膜的存在无关，瓣膜疏通修复术（VSR）比经瓣膜修补修复术（TAP）更早显示恢复情况（P < 0.0001），右室流出压下降程度与术后恢复情况显著相关（P = 0.0204）。由于心内分流和 PaO2/FiO2 比值是肺损伤的不良指标，因此还使用了 Brixia 评分。我们的数据表明，Brixia 评分可作为评估术后肺部状况的最佳替代指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Perioperative Care and Operating Room Management Nursing-Medical and Surgical Nursing

CiteScore

1.30

自引率

0.00%

发文量

审稿时长

56 days

期刊介绍： The objective of this new online journal is to serve as a multidisciplinary, peer-reviewed source of information related to the administrative, economic, operational, safety, and quality aspects of the ambulatory and in-patient operating room and interventional procedural processes. The journal will provide high-quality information and research findings on operational and system-based approaches to ensure safe, coordinated, and high-value periprocedural care. With the current focus on value in health care it is essential that there is a venue for researchers to publish articles on quality improvement process initiatives, process flow modeling, information management, efficient design, cost improvement, use of novel technologies, and management.