To determine the incidence and risk factors for prolonged intensive care unit stay in children with congenital heart diseases undergoing open heart surgeries | [Pakistan Paediatric Journal • 2023]

Author(s):

1. MUJEEB UR REHMAN: Department of Pediatric Cardiology, National Institute of Cardiovascular Diseases, Karachi, Pakistan

2. SAAD BADER ZAKAI: Department of Pediatric Cardiac Surgery, National Institute of Cardiovascular Diseases, Karachi, Pakistan

3. RAJAB ALI KHOKHAR: Department of Pediatric Intensive Care Unit, National Institute of Cardiovascular Diseases, Karachi, Pakistan

4. Abdul Sattar Shaikh Shaikh: National Institute of Cardiovascular Diseases, Karachi, Pakistan

5. Ammad Hussain: National Institute of Cardiovascular Diseases, Karachi, Pakistan

6. Zubair Ahmed: National Institute of Cardiovascular Diseases, Karachi, Pakistan

7. Fazal Ur Rehman: National Institute of Cardiovascular Diseases, Karachi, Pakistan

8. Najma Patel: Department of Pediatric Cardiology, Dr. Ziauddin Hospital, Karachi, Pakistan

Abstract:

Objective: To assess the risk factors for prolonged intensive care unit stay postoperatively in patients with congenital heart disease. Study Design: Observational study. Place and Duration of Study: The study was undertaken at the Intensive Care Unit, Pediatric Cardiac Department at the National Institute of Cardiovascular Diseases, Karachi, Pakistan from August 2021 to February 2022. Material and Methods: All children under the age of 18 years who were admitted to our center for the management of congenital heart diseases such as atrial or ventricular septal defects were eligible to partake in the study. The data related to determinants of prolonged intensive care length of stay in 100 children after cardiac surgery was recorded in a predefined proforma. Complications postoperatively were also reported. All data were analyzed using the statistical package for social sciences (SPSS) version 26. Results: Longer duration of bypass (p=0.001), higher postoperative lactate levels (p<0.0001), decreased postoperative tricuspid annular plane systolic excursion (TAPSE) (p<0.0001), reduced postoperative left ventricular ejection fraction (LVEF) (p=0.006), Postoperative Arterio-venous differences of oxygen (AVDO2) (p<0.0001), and acidosis (p=0.009) were all significantly correlated with prolonged ICU stay. ICU length of stay correlated significantly with certain complications including low cardiac output (p=0.0003), arrhythmias (p=0.0005), and right ventricle dysfunction (p=0.0006). Conclusion: The present study identifies various patient outcomes and complications including postoperative low cardiac output, arrhythmias, and right ventricular dysfunction, and reduced left ventricular ejection fraction that were significantly correlated with prolonged ICU stay.

Page(s): 227-234

DOI: DOI not available

Published: Journal: Pakistan Paediatric Journal, Volume: 47, Issue: 3, Year: 2023

Keywords:

Children , Pediatric , Hospitalization , Critical care , Congenital cardiac disease , Intensive care unit stay

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