Wiriya Maisat, Koichi Yuki
Boston Children’s Hospital and Harvard Medical School.
United States
Journal of Cardiothoracic and Vascular Anesthesia
J Cardiothorac Vasc Anesth 2022; 36: 2500-2508
DOI: 10.1053/j.jvca.2022.02.024
Abstract
Objective: To investigate the predictive factors for postoperative intensive care unit (ICU) admission and mechanical ventilation (MV) after cardiac catheterization for pediatric pulmonary vein stenosis (PVS).
Design: A retrospective observational study.
Setting: At a single tertiary academic pediatric medical center.
Participants: Four hundred seventy-three pediatric patients diagnosed with PVS and who underwent cardiac catheterization from 2011 to 2021.
Measurements and main results: Univariate and multivariate analyses were performed for associated risk factors. The incidence of postoperative ICU admission was 46.5% (n = 220); among these, 93.4% (n = 206) required MV. Independent risk factors included male sex (odds ratio [OR] 3.93, p = 0.002 in ICU group; OR 2.89, p = 0.013 in MV group), low body weight (OR 0.80, p = 0.003 in ICU group; OR 0.79, p = 0.002 in MV group), preoperative oxygen supplement (OR 4.01, p = 0.002 in ICU group; OR 3.67, p = 0.003 in MV group), high PVS severity score (OR 1.15, p = 0.028 in ICU group), intraoperative hypotension requiring inotrope (OR 4.03, p = 0.011 in ICU group; OR 2.89, p = 0.035 in MV group), intraoperative red blood cell transfusion (OR 3.25, p = 0.023 in ICU group; OR 4.09, p = 0.005 in MV group), low preintervention PaO2/FIO2 ratio (OR 0.63, p = 0.009 in ICU group; OR 0.59, p = 0.002 in MV group), and high preintervention right ventricular systolic pressure (OR 1.39, p = 0.004 in ICU group; OR 1.27, p = 0.023 in MV group).
Conclusion: The incidences of postoperative ICU admission and MV in this subgroup were relatively high. The identification of risk factors is useful in predicting and triaging the need for postoperative ICU admission and MV for the improvement of patient care.
Category
Catheter-mediated Interventions: Adverse Effects or Lack of Adverse Effects
Patient Factors Influencing the Onset, Severity or Outcome of Disease
Year of Publication: 2022
Age Focus: Pediatric
Article Type: Retrospective Observational Cohort Studies (>10 patients)
Article Access: Free PDF File or Full Text Article Available Through PubMed or DOI: No