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Outcome of low body weight (<2.2 kg) infants undergoing cardiac surgery
Akhter Mehmood1, Sameh R Ismail1, Mohamed S Kabbani1
1King Abdulaziz Medical City, King Saud University for Health Sciences, Department of Cardiac Sciences, National Guard Hospital Health Affairs, Riyadh.
Insights
Infants with low body weight (<2.2 kg) undergoing cardiac surgery face higher ICU morbidity and mortality risks. While outcomes can be satisfactory, careful post-operative care is crucial for these vulnerable patients.
Area of Science:
- Pediatric Cardiac Surgery
- Neonatal Intensive Care
- Cardiovascular Research
Background:
- Low body weight (LBW) infants present significant challenges in post-cardiac surgery care.
- LBW infants historically show poorer outcomes compared to normal weight infants after cardiac operations.
Purpose of the Study:
- To compare the postoperative course and outcomes of LBW infants (<2.2 kg) with normal body weight infants undergoing similar cardiac surgeries.
- To identify specific risks and complications associated with cardiac surgery in LBW infants.
Main Methods:
- Retrospective review of infants (<2.2 kg) undergoing cardiac operations from 2001-2011.
- Comparison of LBW infants (Group A) with matched normal body weight infants (Group B) based on surgical risk.
- Analysis of demographic data, ICU parameters, complications, and short-term outcomes.
Main Results:
- No demographic differences between groups except for weight (2.13±0.08 kg vs 3.17±0.2 kg).
- LBW infants experienced longer bypass times, increased need for inotropes and mechanical ventilation, and more re-intubations.
- LBW infants had a significantly longer Pediatric Cardiac Intensive Care Unit (PCICU) length of stay and a 13.5% hospital mortality rate compared to 0% in the normal weight group.
Conclusions:
- Cardiac surgery in LBW infants (<2.2 kg) can yield satisfactory results but is associated with increased ICU morbidity.
- LBW infants undergoing cardiac surgery face a significantly higher risk of mortality.
- Enhanced monitoring and tailored post-operative care are essential for improving outcomes in LBW infants.
Introduction:
Infants with low body weight (LBW) following cardiac surgery are a major challenge for the post cardiac surgery care unit. It has been observed that post surgery outcome for LBW infants is worse compared to the outcome of normal body weight infants. A study was conducted to compare post operative course and outcome of infants with body weight of 2.2 kg or less against infants with normal body weight who underwent similar cardiac surgeries.
Methods:
A retrospective review was performed for all infants below 2.2 kg who underwent cardiac operations at King Abdulaziz Cardiac Center from January 2001 to October 2011. Cases with LBW (Group A) were compared with matching group (Group B) of normal body weight infants who had similar cardiac surgeries and matching surgical risk category. The demographic, ICU parameters, complications, and short-term outcome of both groups were analyzed.
Results:
Two groups were formed, with 37 patients in Group A, and 39 patients in Group B. Except for weight (2.13 ± 0.08 kg in Group A vs 3.17 ± 0.2 kg in Group B), there was no statistical difference in demographic data between both groups. Cardiac procedures included coarctation repair, arterial switch, ventricular septal defect (VSD) repair, tetralogy of Fallot repair, systemic to pulmonary shunt and Norwood procedures. Patients in Group A had statistically significant difference from Group B in terms of bypass time (p = 0.01), duration of inotropes (p = 0.01), duration of mechanical ventilation (p = 0.004), number of re-intubations (p = 0.015), PCICU length of stay (p = 0.007), and hospital mortality: 13.5% in Group A vs 0% in Group B (p value 0.02).
Conclusion:
Patients with LBW (<2.2 kg) underwent cardiac surgery with overall satisfactory results, but with increased risk of ICU morbidity and mortality.
