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Risk Factors for Delayed Extubation after Ventricular Septal Defect Closure: a Prospective Observational Study
Divyakant Parmar1, Ketav Lakhia2, Pankaj Garg2
1Department of Cardiac Anesthesia of the U. N. Mehta Institute of Cardiology and Research Center (affiliated to BJ Medical College, Ahmedabad), Gujarat, India.
Brazilian Journal of Cardiovascular Surgery
|October 5, 2017
Summary
Early extubation after pediatric ventricular septal defect closure is feasible. Key risk factors for delayed extubation include trisomy 21, low cardiac output syndrome, multiple VSDs, and high vasoactive-inotropic scores.
Area of Science:
- Pediatric Cardiac Surgery
- Critical Care Medicine
- Congenital Heart Disease
Background:
- Ventricular septal defect (VSD) closure is a common pediatric cardiac surgery.
- Early extubation post-cardiac surgery is associated with improved outcomes.
- Identifying factors influencing extubation time is crucial for optimizing patient recovery.
Purpose of the Study:
- To assess the feasibility of early extubation in pediatric patients undergoing VSD closure.
- To identify significant risk factors associated with delayed extubation in this population.
Main Methods:
- A prospective, observational study included 135 pediatric patients undergoing VSD closure.
- Patients were targeted for extubation within six hours post-surgery.
- Patients were categorized into early (≤6 hours) and delayed (>6 hours) extubation groups.
Main Results:
- 99 patients (Group 1) were extubated early, while 36 (Group 2) experienced delayed extubation.
- Delayed extubation was significantly associated with trisomy 21, low cardiac output syndrome, multiple VSDs, and high vasoactive-inotropic score.
- Factors like age, weight, and cardiopulmonary bypass time did not significantly impact extubation timing.
Conclusions:
- Trisomy 21, low cardiac output syndrome, multiple VSDs, and high vasoactive-inotropic score are independent predictors of delayed extubation.
- Early extubation is feasible, but specific patient factors necessitate careful management to avoid delays.
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