scholarly journals Relationship Between Intraoperative Cerebral Desaturation and Postoperative Complications In Pediatric Patients Undergoing Congenital Heart Surgery: Prospective Cohort Study

2021 ◽  
Author(s):  
Cengiz Han Sahutoğlu ◽  
Seden Kocabaş ◽  
Fatma Zekiye Askar
Keyword(s):  
Postoperative Complications ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Multiple Logistic Regression Analysis ◽  
Open Heart Surgery ◽  
Congenital Heart Surgery ◽  
University Hospital ◽  
Alarm Limit ◽  
Cerebral Desaturation ◽  
Group 1

Objective: In this study, we aimed to investigate the incidence of cerebral desaturation and the possible relationship between intraoperative cerebral desaturation and postoperative complications. Methods: A prospective, observational study was performed 115 patients under 18 years of age who required open heart surgery in a university hospital. Cerebral desaturation was defined as a 25% decrease in cerebral saturation (low alarm limit) when compared with the basal value. Duration (second) was referred to the amount of time the patient stays below low alarm limit. Depth (%) was referred to gap between the patient’s cerebral regional oxygen saturation (rSO2) level and the rSO2 low alarm limit. The cerebral desaturation score was calculated using the %*seconds. The patients were divided into two groups: group 1 (desaturation score >3000 %sec) and group 2 (desaturation score ≤ 3000 %sec). The groups were compared in terms of demographic data, intraoperative and postoperative variables, postoperative complications, and duration of intensive care and hospital stays. Results: In the study, 59 patients (51.3%) were male and 28 patients (24.3%) had cyanotic heart disease. A total of 55 patients (47.8%) experienced over 3000 %sec desaturation. Postoperative complications were found to be increased in group 1 (71% vs 3.3%; χ²=57.119, p<0.001). In the multiple logistic regression analysis, desaturation score>3000 %sec (p<0.001), low body surface area (p=0.001) and prolonged cardiopulmonary bypass (p=0.006) were found to be associated with postoperative complications. Conclusion: In patients undergoing congenital heart surgery, cerebral desaturation score >3000 %sec is associated with a negative effect on patient prognosis.

Risk-stratified outcome of congenital heart surgery in Assiut University Hospital

2019 ◽  
Vol 4 (1) ◽  
pp. 25
Author(s):  
KhaledA Kassem ◽  
MostafaA Abdelaziz ◽  
AhmedI Ismael ◽  
AhmedM Ghoneim
Keyword(s):  
Congenital Heart ◽  
Heart Surgery ◽  
Congenital Heart Surgery ◽  
University Hospital

scholarly journals Evaluation of Complications of Heart Surgery in Children With Congenital Heart Disease at Dena Hospital of Shiraz

2015 ◽  
Vol 8 (5) ◽  
pp. 33 ◽  
Author(s):  
Maryam Mirzaei ◽  
Samaneh Mirzaei ◽  
Elham Sepahvand ◽  
Afifeh Rahmanian Koshkaki ◽  
Marzieh Kargar Jahromi
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Vascular Complications ◽  
Congenital Heart Surgery ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Cross Sectional

<p><strong>INTRODUCTION:</strong> Today, with progress in the field of congenital heart surgery, different complicated actions are done in children. These actions may be associated with several complications, especially open heart surgery in which the cardiopulmonary bypass (CPB) is used. Serious complications can be caused high morbidity and mortality rates. Present study has been performed to determine the incidence of morbidity and mortality in cardiac surgery in children.</p> <p><strong>METHOD:</strong> In a cross-sectional retrospective, records of 203 patients undergoing surgery for congenital heart disease in Dena hospital during 2013-2015 were reviewed for incidence of complications. Data was analyzed by using descriptive and analytical statistics and using SPSS version 18.</p> <p><strong>RESULTS:</strong> The mean age of samples was 3/65±4/47 years. The majority of samples (73/8%) were undergoing open surgery. The overall adverse cardiovascular complications were respectively, renal complications (44/3%), lung (40/3%), anemia (35/9%), heart (34/4%), gastrointestinal (17/2%), brain (14/2%), need for re-intubation of the trachea 11/3%), infection (7/8%) required reoperation (5/9%) and vascular complications (1/4%).</p> <p><strong>CONCLUSION:</strong> High incidence of complications after congenital heart surgery makes necessary attention to complications and their treatment after surgery. It is necessary to apply the measures and careful monitoring of patients to minimize these effects.</p>

Reimbursement After Congenital Heart Surgery in Germany: Impact of Early Postoperative Extubation

2020 ◽  
Vol 11 (5) ◽  
pp. 557-562 ◽  
Author(s):  
Peter Murin ◽  
Viktoria Weixler ◽  
Mi-Young Cho ◽  
Valentin Vadiunec ◽  
Oliver Miera ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Congenital Heart Surgery ◽  
Case Mix ◽  
Open Heart ◽  
Early Extubation ◽  
Cost Weight ◽  
Case Mix Index

Background: Duration of mechanical ventilation is an important variable used by German Diagnosis-Related Groups (G-DRG) system to establish cost weight values for reimbursement after congenital heart surgery. Infants are commonly ventilated after open heart surgery. As of year 2015, we strived to achieve early postoperative extubation. This work studies how this approach impacted reimbursement after infant open heart surgery. Methods: Data of infants who underwent surgery on cardiopulmonary bypass (CPB) from 2014 to 2018 were reviewed. Successful early extubation was defined as end of mechanical ventilation within 24 hours postoperatively, without reintubation at a later point. Mean cost weight values (case mix index [CMI]) of achieved DRGs were used for estimation of reimbursement. Evolutions over years of early extubation and of reimbursement were compared. Results: A total of 521 infants underwent operations on CPB. Of these, 161 (31%) procedures were of higher risk Society of Thoracic Surgery and the European Association for Cardio-Thoracic Surgery (STAT) categories 3 and 4. Early extubation was achieved in 205 (39%) patients. The rate increased from 14% (year 2014) to 57% (year 2018). Case mix index amounted to 8.87 ± 7.00 after early extubation, and 12.37 ± 7.85 after late extubation: P value <.0001. It was 8.77 ± 6.09 after early extubation in patients undergoing lower risk STAT categories 1 and 2 operations, and 8.09 ± 2.95 when categories 3 and 4 procedures were performed ( P = .18). An overall 14.4% decrease in hospital reimbursement per patient was observed. Conclusion: Early extubation could be progressively obtained in the majority of infants. This resulted in lower reimbursement. Surgical complexity was disregarded. The current G-DRG system appears to favor longer mechanical ventilation durations after infant open heart surgery.

scholarly journals LONG-TERM TRANSPLANT-FREE SURVIVAL AFTER CONGENITAL HEART SURGERY

2021 ◽  
Vol 77 (18) ◽  
pp. 481
Author(s):  
Lazaros Kochilas ◽  
Amanda Thomas ◽  
Chao Zhang ◽  
J’Neka Claxton ◽  
Courtney McCracken ◽  
...  
Keyword(s):  
Congenital Heart ◽  
Heart Surgery ◽  
Congenital Heart Surgery ◽  
Free Survival
Sign in / Sign up

Export Citation Format

Share Document