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Author Spotlight: Simulating Pediatric Cardiac Surgery Using a Neonatal Piglet Model
Published on: May 26, 2023
Definition of important early morbidities related to paediatric cardiac surgery
Katherine L Brown1, Christina Pagel2, Rhian Brimmell3
11Cardiac,Critical Care and Respiratory Division,Great Ormond Street Hospital NHS Foundation Trust,London,United Kingdom.
Insights
A prioritized list of morbidities after pediatric cardiac surgery was defined, including neurological events and unplanned re-operations. This framework aids routine audit and quality assurance for better patient outcomes.
Area of Science:
- Pediatric Cardiac Surgery
- Clinical Quality Improvement
- Patient Safety
Background:
- Postoperative morbidity in pediatric cardiac surgery presents significant challenges.
- Defining and measuring morbidity is crucial for quality assurance and improving patient care.
Purpose of the Study:
- To define a prioritized list of morbidities following pediatric cardiac surgery.
- To establish a consensus on key adverse events for routine audit.
Main Methods:
- A multi-disciplinary group developed a list of morbidities.
- A panel, including professionals, parents, and patients, prioritized the defined morbidities.
Main Results:
- A ranked list of pediatric cardiac surgical morbidities was established.
- Key morbidities include acute neurological events, unplanned re-operations, and renal support needs.
- Definitions are suitable for routine audit and quality assessment.
Conclusions:
- Defining pediatric cardiac surgical morbidities is feasible and reflects stakeholder priorities.
- This framework supports routine audit and quality improvement initiatives.
- Further prospective studies will explore the impact on patients and families.
Background:
Morbidity is defined as a state of being unhealthy or of experiencing an aspect of health that is "generally bad for you", and postoperative morbidity linked to paediatric cardiac surgery encompasses a range of conditions that may impact the patient and are potential targets for quality assurance.
Methods:
As part of a wider study, a multi-disciplinary group of professionals aimed to define a list of morbidities linked to paediatric cardiac surgery that was prioritised by a panel reflecting the views of both professionals from a range of disciplines and settings as well as parents and patients.
Results:
We present a set of definitions of morbidity for use in routine audit after paediatric cardiac surgery. These morbidities are ranked in priority order as acute neurological event, unplanned re-operation, feeding problems, the need for renal support, major adverse cardiac events or never events, extracorporeal life support, necrotising enterocolitis, surgical site of blood stream infection, and prolonged pleural effusion or chylothorax. It is recognised that more than one such morbidity may arise in the same patient and these are referred to as multiple morbidities, except in the case of extracorporeal life support, which is a stand-alone constellation of morbidity.
Conclusions:
It is feasible to define a range of paediatric cardiac surgical morbidities for use in routine audit that reflects the priorities of both professionals and parents. The impact of these morbidities on the patient and family will be explored prospectively as part of a wider ongoing, multi-centre study.
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