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Errors and mistakes in surveying refer to inaccuracies in measurements and data recording. The errors are deviations from the actual value caused by human sensory limitations, equipment flaws, or environmental effects. These errors are typically unintentional and can result from the inherent imperfections in the instruments used, atmospheric conditions, or the observer’s inability to perceive exact measurements. On the other hand, mistakes are caused by the surveyor's lack of...
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Post-operative practice patterns after the bidirectional Glenn surgery: a survey.

Bennett Weinerman1,2, Soon Bin Kwon2,3, Eva W Cheung1

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Postoperative care for children after bidirectional Glenn surgery lacks consensus among providers. This study reveals varied management strategies and highlights the need for standardized, evidence-based targets to optimize patient outcomes.

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Area of Science:

  • Pediatric Cardiology
  • Cardiac Surgery
  • Intensive Care Medicine

Background:

  • The bidirectional Glenn surgery is a critical staging procedure for single ventricle congenital heart disease (CHD).
  • Optimal postoperative management strategies for these patients remain under-researched.
  • An estimated 1000 US children annually require this intervention for CHD.

Purpose of the Study:

  • To survey pediatric cardiac intensive care providers on their management strategies post-bidirectional Glenn surgery.
  • To identify current practices and areas of consensus or variability in postoperative care.
  • To underscore the need for standardized management protocols.

Main Methods:

  • An anonymous, 12-question web-based survey was emailed to pediatric cardiac intensive care providers.
  • The survey collected demographic data and focused on postoperative physiologic targets.
  • Thirty-five providers, mostly attendings with extensive training, responded.

Main Results:

  • A significant lack of consensus exists regarding postoperative management after bidirectional Glenn surgery.
  • Less than 75% consensus was observed for specific targets including SpO2, mean arterial pressure, and pH.
  • Practice patterns are highly variable, indicating a need for optimized care strategies.

Conclusions:

  • Current postoperative care for bidirectional Glenn surgery patients is characterized by significant provider variability.
  • There is a clear need for the development of evidence-based, outcome-driven targets.
  • Standardized protocols are essential to optimize the care and outcomes for these vulnerable children.