Prolonged Mechanical Ventilation Among Children With Congenital Heart Disease Undergoing Cardiac Surgery In Philippine Heart Center: A Risk Factors Analysis

2011 ◽  
Author(s):  
CHARINA M. LAGYAL ◽  
Theresita De Guia ◽  
Fernando Ayuyao ◽  
Milagros Bautista
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Congenital Heart ◽  
Prolonged Mechanical Ventilation ◽  
Factors Analysis ◽  
Heart Center

scholarly journals Predictive role of perioperative neutrophil to lymphocyte ratio in pediatric congenital heart disease associated with pulmonary arterial hypertension

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaoqiang Yin ◽  
Mei Xin ◽  
Sheng Ding ◽  
Feng Gao ◽  
Fan Wu ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Congenital Heart ◽  
Prolonged Mechanical Ventilation ◽  
Pulmonary Arterial ◽  
Mechanical Ventilation Time

Abstract Background We aimed to explore the relationship between the neutrophil to lymphocyte ratio (NLR) and the early clinical outcomes in children with congenital heart disease (CHD) associated with pulmonary arterial hypertension (PAH) after cardiac surgery. Methods A retrospective observational study involving 190 children from January 2013 to August 2019 was conducted. Perioperative clinical and biochemical data were collected. Results We found that pre-operative NLR was significantly correlated with AST, STB, CR and UA (P < 0.05), while post-operative NLR was significantly correlated with ALT, AST, BUN (P < 0.05). Increased post-operative neutrophil count and NLR as well as decreased lymphocyte count could be observed after cardiac surgery (P < 0.05). Level of pre-operative NLR was significantly correlated with mechanical ventilation time, ICU stay time and total length of stay (P < 0.05), while level of post-operative NLR was only significantly correlated to the first two (P < 0.05). By using ROC curve analysis, relevant areas under the curve for predicting prolonged mechanical ventilation time beyond 24 h, 48 h and 72 h by NLR were statistically significant (P < 0.05). Conclusion For patients with CHD-PAH, NLR was closely related to early post-operative complications and clinical outcomes, and could act as a novel marker to predict the occurrence of prolonged mechanical ventilation.

Nineteen Years of Adult Congenital Heart Surgery in a Single Center

2017 ◽  
Vol 8 (2) ◽  
pp. 182-188
Author(s):  
Madurra Perinpanayagam ◽  
Signe H. Larsen ◽  
Kristian Emmertsen ◽  
Marianne B. Møller ◽  
Vibeke E. Hjortdal
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Postoperative Complications ◽  
Adverse Events ◽  
Congenital Heart ◽  
Postoperative Bleeding ◽  
Registration System ◽  
Growing Population

Background: Adults with congenital heart disease are a growing population. We describe surgical interventions, short- and long-term mortality and morbidity, and risk factors for adverse events in a population-based cohort. Methods: Patients over or equal to 18 years with congenital heart disease who underwent cardiac surgery at Aarhus University Hospital, Denmark, from 1994 to 2012 were included in the study. Diagnoses, surgical procedures, postoperative complications, and survival were identified in hospital databases, medical records, and the Danish Civil Registration System. Results: Four hundred seventy-four surgeries were performed in 445 adults (50% men). The median age was 39 years (range 18-83). Thirty-nine percent had previous surgical or catheter-based interventions. Thirty-day and in-hospital mortality were 1.1%. Postoperative complications occurred in 50% of cases, most were minor such as temporary arrhythmias and pneumonia. Major complications included postoperative bleeding necessitating intervention (6%), stroke (2%), and acute temporary renal failure (1%). Multivariate analysis identified RACHS-1 categories over or equal to 3 compared to category 1 (odds ratio (OR) = 2.3; 95% confidence interval (CI): 1.5-3.7), New York Heart Association functional class III and IV compared to class I (OR = 2.2; 95% CI: 1.3-3.7) and age at surgery (OR = 1.03, 95% CI: 1.01-1.04), as risk factors for adverse events. Survival during a median follow-up of 7.8 years (range 0 days-21.4 years) was 85% (95% CI: 80%-89%). Conclusion: Adults with congenital heart disease constitute a growing population with the need for cardiac surgery. Postoperative complications are frequent but early and late mortality are low.

scholarly journals The diagnostic value of combined indexes in Acute Renal injury after Cardiopulmonary Bypass Surgery in infants with Congenital Heart Disease

2020 ◽  
Author(s):  
Haifei Yu ◽  
Xinrui Wang ◽  
Qiang Chen ◽  
Liangpu Xu ◽  
Hua Cao
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Cardiopulmonary Bypass ◽  
Congenital Heart ◽  
Hepatic Function ◽  
Blood Oxygen ◽  
Acute Renal Injury ◽  
Blood Oxygen Saturation

Abstract Objective: To investigate the incidence and risk factors of acute renal injury (AKI) after cardiopulmonary bypass (CPB) cardiac surgery in infants with congenital heart disease(CHD). Methods: Single-center data from a total of 613 infants with congenital heart disease who underwent cardiothoracic surgery in Fujian Union Hospital.The included patients were divided into two groups according to the occurrence of AKI: AKI group (n = 68) and non-AKI group (n = 92). We obtained clinical data from the electronic hospitalization information system and the laboratory database. All infants were tested for serum creatinine at least twice within 12 hours of admission and after operation. We determined AKI events according to creatinine criteria for improving global prognosis of renal diseases.The general and clinical data of the infants were collected, and the related risk factors were explored by univariate analysis and Logistic regression analysis. Results: 160 patients had congruent lab and echocardiogram data foranalysis. Most of patients are male (56.26%). Original congenital cardiac malformation is similar with our study, the most common is left-to-right shunt CHD(58%), followed by right-to-left shunt CHD(18.75%). All patients showed differences in liver function, renal function, cardiac function and inflammatory indexes within 12 hours of admission and after operation(p<0.05). The AKI group and non-AKI group showed Significant statistical difference in arein age, serum myocardial enzyme , hepatic function, ejection fraction , hemoglobin , platelet count were significantly different meaning (p<0.05). Regression analyses showed that blood oxygen saturation (95%CI 1.003-2.999), CREA(95%CI 1.070-1.253), UREA(95%CI 1.180-3.325), CRP(95%CI 1.006-1.058), BNP(95%CI 0.999-1.000) at 12 hours postoperatively, and in admission to PCT (95%CI 0.461-0.936), Neu(95%CI 0.909-0.995), ALP(95%CI 1.070-1.253) , nadir intraoperative renal regional tissue oximetry to be independent predictors of postoperative kidney damage as measured by blood oxygen saturation, hepatic function, kidney function, cardiac function , Serum myocardial enzyme , inflammatory factor s and blood Routine . Conclusions: Choosing the best age for infants's cardiac surgery, actively preventing preoperative complica- tions, postoperative pneumonia, heart failure and hypoxia play an important role in preventing AKI.

Prolonged Candidemia in Infants Following Surgery for Congenital Heart Disease

2003 ◽  
Vol 24 (10) ◽  
pp. 753-757 ◽  
Author(s):  
Chandrama Chakrabarti ◽  
Sunil K. Sood ◽  
Vincent Parnell ◽  
Lorry G. Rubin
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Congenital Heart ◽  
Case Control Study ◽  
Case Control ◽  
Complex Congenital Heart Disease ◽  
Common Source ◽  
Control Study

AbstractObjectives:To describe a group of infants with complex congenital heart disease (CCHD) who had candidemia postoperatively and to perform a case–control study of risk factors.Design:Descriptive and case–control study.Setting:Tertiary-care medical centers.Patients:Infants with CCHD who underwent cardiac surgery and developed candidemia. Controls were matched for congenital heart disease lesions, age, and postoperative hospital stay.Results:Of 95 infants younger than 6 months with CCHD who underwent cardiac surgery between January 1999 and April 2001, 6 (6.3%) developed candidemia with 5 different species. The candidemia was prolonged (range, 12 to 32 days; median, 17 days). The interval between cardiac surgery and onset of candidemia was 12 to 57 days (median, 24 days). All had a central venous catheter inserted 8 to 50 days prior to the onset of candidemia. The mortality rate was 83%, compared with 13% for the group without candidemia. A univariate analysis of the potential risk factors revealed that duration of total parenteral nutrition (TPN), duration of antibiotics, intraoperative cardiopulmonary bypass time, and documentation of an intravascular thrombus were associated with candidemia. In multivariate analysis, long duration of TPN and documentation of a thrombus were associated with candidemia.Conclusions:Candidemia following cardiac surgery for infants with CCHD was persistent and associated with high mortality. The variety of species indicates that this was not a common-source outbreak. Risk factors associated with candidemia were duration of TPN and documentation of an intravascular thrombus.

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