Zeng Min,Li Shengli,Duan Leilei,et al.Influencing factors for early extubation in neonates and young infants following surgical repair of complex congenital heart disease[J].Journal of Clinical Pediatric Surgery,,21():364-369.[doi:10.3760/cma.j.cn101785-202104018-013]
Influencing factors for early extubation in neonates and young infants following surgical repair of complex congenital heart disease
- Keywords:
- Heart Diseases/CN; Heart Diseases/SU; Airway Extubation/MT; Infant; Newborn; Infant
- Abstract:
- ObjectiveTo analyze the clinical outcomes and to explore the feasibility and influencing factors of early extubation (EE) in neonates and young infants after congenital heart disease (CHD) repair.MethodsWe conducted a retrospective analysis of neonate and young infants with CHD who underwent cardiac surgery at Fuwai Hospital between January 1,2017,and December 31,2019.A total of 391 patients were included.According to the mechanical ventilator time (MVT) after admitted to the PICU,patients were divided into two groups:EE group (MVT <24 h) and nonEE group (MVT>24 h).Univariate and multivariate analysis was used to identify the risk factors for EE.Complications and clinical outcomes were compared between the EE group and the nonEE group.ResultsIn univariate analysis,the significantly differences were found in age,weight,ACC time,CPB time,and RACHS-1.Multivariate logistic regression analysis indicated that low weight (OR=0.648,95%CI:0.471~0.893)and BT procedure(OR=0.109,95%CI:0.013~0.934) were independent risk factors for EE.Overall,EE was achieved in 65% of all cases.Operative mortality was 2.3%,and no patient died in the EE group.The total number of neonates was 136 accounting for 34.9% of all patients,and the EE rate in neonates was 58.8%.The MVT and ICU length of stay in the EE group were shorter than that in the nonEE group (P<0.001).The re-intubation rate(3.15% vs.12.4%) and postoperative infection rate(1.18% vs.14.6%)in the EE group were lower compared with that in the nonEE group (P<0.05).ConclusionMost neonates and infants with complex CHD can achieve EE after surgery.EE was associated with a lower postoperative infection rate and shorter length of stay of ICU and MVT.Low body weight and BT procedure are independent risk factors for EE in neonates and young infants following complex CHD repair.
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Memo
收稿日期:2021-04-10;改回日期:。
基金项目:北京协和医学院教育教学改革项目(10023201800203);"十三五"国家重点研发计划项目(2017YFC1308100)
通讯作者:王旭,Email:fwpicu@163.com