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Critical Care |

Predictors of Postoperative Pulmonary Complications in Children Undergoing Cardiothoracic Surgery at the Philippine Heart Center (PREdICt Phase I)

Maria Niña Banque*, MD; Ma. Dulce Requiron-Sy, MD; Maria Nerissa De Leon, MD; Milagros Bautista, MD; Ma. Encarnita Limpin, MD
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Philippine Heart Center, Quezon City, Philippines


Chest. 2012;142(4_MeetingAbstracts):403A. doi:10.1378/chest.1364265
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Abstract

SESSION TYPE: Post operative ICU issues Posters

PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM

PURPOSE: This is a prospective observational cohort study done to determine the risk factors associated with postoperative pulmonary complications (PPCs) following cardiothoracic surgery in children 6 years old and below who underwent cardiothoracic surgery from November 1, 2010-October 31, 2011 at the Philippine Heart Center

METHODS: The following variables were included in the study: demographic and clinical characteristics, identified preoperative risk factors, ASA and RACHS-1 scores, surgical procedures done, bypass time, aortic cross clamp time, duration of postoperative mechanical ventilation, recovery room (RR) stay, pediatric intensive care unit (PICU) stay, overall length of postoperative hospital stay and condition on discharge. Patients were then observed for development of PPCs.

RESULTS: A total of 120 patients were included in the study, 52 of whom performed tidal breathing analysis. The rate of PPCs in this study is 73% with atelectasis as the most common. The presence of PPCs are associated with prolonged need for mechanical ventilation, longer RR, PICU and hospital stay postoperatively. There were 14(12%) who died in the study, all with PPCs. There is the tendency that as the number of PPCs increases, the rate of mortality also increases. Risk factors associated with PPCs were history of respiratory tract infection (RTI), preoperative mechanical ventilation, high pulmonary artery pressure (PAP), hypercarbia, hemoconcentration, lymphocytopenia, prolonged protime, hypoalbuminemia, high RACHS -1and ASA score. Logistic regression analysis however, only showed history of RTI and preoperative mechanical ventilation as independent risk factors.

CONCLUSIONS: Incidence of PPCs in children 6 years old and below undergoing cardiothoracic surgery is high and is associated with prolonged need for mechanical ventilation, longer RR, PICU and hospital stay postoperatively.

CLINICAL IMPLICATIONS: With the high incidence of PPCs in this age group, identifying the risk factors to prevent its occurrence is of paramount importance.

DISCLOSURE: The following authors have nothing to disclose: Maria Niña Banque, Ma. Dulce Requiron-Sy, Maria Nerissa De Leon, Milagros Bautista, Ma. Encarnita Limpin

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Philippine Heart Center, Quezon City, Philippines

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