Impact of Cardiopulmonary Bypass and Aorta Cross Clamp Time on the Length of Mechanical Ventilation after Cardiac Surgery among Children: A Saudi Arabian Experience

• Published in: Curēus (Palo Alto, CA) Vol. 11; no. 8; p. e5333
• Main Authors: Mehmood, Akhter, Nadeem, Rashid N, Kabbani, M S, Khan, Altaf H, Hijazi, Omar, Ismail, Sameh, Shath, Ghassan, Eng, Winston W, Jawed, Shafaq
• Format: Journal Article
• Language: English
• Published: Palo Alto Cureus Inc 07.08.2019; Cureus
• Subjects: Cardiovascular disease; Clinical outcomes; Congenital diseases; Coronary vessels; Gastroesophageal reflux; Heart surgery; Hospitals; Intensive care; Internal Medicine; Medical records; Military reserves; Mortality; Patients; Pediatric Surgery; Pediatrics; Pneumonia; Surgical techniques; Urinary tract infections; Variables; Ventilators; United States > US; Riyadh Saudi Arabia; Dubai United Arab Emirates
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.5333

AimSeveral factors determine the perioperative outcome besides the nature of the congenital heart defect. Prolonged mechanical ventilation (PMV) is a major factor that determines mortality, length of stay (LOS), residual disability, and other functional outcomes. We aim to determine the clinical variables predicting PMV and LOS in hospital, and specifically the impact from the duration of cardiopulmonary bypass (CPB) and aortic cross-clamp (ACC).MethodWe conducted a retrospective review of the medical records of 413 children consecutively admitted to the Pediatric Cardiac Intensive Care Unit (PCICU) in one year at a single center. We collected demographic information (e.g., age, gender, and weight), perioperative variables, clinical outcomes, length of mechanical ventilation, high-frequency ventilator use, and mortality. We used logistic regression to analyze the data. PMV was defined as mechanical ventilation for longer than seven days.ResultsA total of 410 records were included in our study. We found no statistically significant association between CPB time and mechanical ventilation days. Forty-seven children had PMV, 362 did not have PMV. We found no statistically significant association between CPB time and mechanical ventilation days after adjusting for covariates. Reanalyzing the data with PMV defined as longer than four days produced the same results. Using a regression model to assess the variables via the least absolute shrinkage and selection operator for feature selection, we found no statistically significant association between ACC time and mechanical ventilation days after adjusting for covariates.ConclusionAccording to our results, CPB and ACC time are not associated with PMV or prolonged hospital LOS.