Study objectives: To identify pulmonary risk factors
associated with prolonged ICU stay in young children (≤ 2 years)
undergoing surgical repair for congenital heart disease (CHD).
Design: Retrospective case series analysis.
Setting: Tertiary-care facility.
Clinical records of 134 consecutive patients aged ≤ 2 years
undergoing cardiac surgery for CHD were reviewed, and 37 were excluded
according to inclusion criteria. Thus, 97 patients were allocated to
two groups based on the duration of ICU stay: ≤ 7 days (group 1,
n = 57), and > 7 days (group 2, n = 40).
Results: Mean ICU duration for groups 1 and 2 was
3.0 ± 0.4 days and 28.1 ± 4.4 days, respectively (p < 0.001).
In group 1, there were three extubation failures, whereas 41 extubation
failures occurred in group 2 (p < 0.0001). A total of 22 patients (4
in group 1 and 18 in group 2) developed noninfectious pulmonary
complications, such as airway problems, including extrinsic airway
compression and tracheobronchomalacia (n = 6); pulmonary hypertension
(n = 5); phrenic nerve palsy (n = 7); and pleural effusion
(n = 8). These 22 patients (23%) contributed to the majority of
total ventilator days (67%) as well as ICU stay (61%).
Conclusions: Pulmonary complications in general, and
central airway problems in particular, are a frequent cause for delayed
recovery following cardiac surgery in young children.