Risk Factors Associated With Prolonged Mechanical Ventilation and Length of Stay After Repair of Tetralogy of Fallot

Kesumarini, Dian and Widyastuti, Yunita and Boom, Cindy Elfira and Dinarti, Lucia Kris (2024) Risk Factors Associated With Prolonged Mechanical Ventilation and Length of Stay After Repair of Tetralogy of Fallot. World Journal for Pediatric and Congenital Heart Surgery, 15 (1). 81 -88. ISSN 21501351

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Abstract

Background: This study examined preoperative, intraoperative, and postoperative data to identify factors that are associated with prolonged mechanical ventilation (PMV) and prolonged intensive care unit length of stay (ICU LOS) in tetralogy of Fallot (TOF) patients undergoing repair surgery. Methods: A retrospective study was carried out after approval from the institutional review board. All patients (age 0-52 years) who underwent TOF repair from January 2016 to September 2022 were included. Prolonged mechanical ventilation was defined as >24 h of ventilation, while prolonged ICU LOS was defined as ICU stay >3 days. Results: A total of 922 patients were included, among whom 288 (31.2) were intubated for >24 h and 222 (24.1) stayed in ICU for >3 days. Younger age (odds ratio OR = 2, 95% confidence interval CI 1.2-3.3, P =.007), lower weight (OR = 2.1, 95% CI 1.2-3.5, P =.003), and residual lesion (OR = 3.27, 95% CI 1.2-8.7, P =.017) were associated with PMV. Moreover, independent risk factors for prolonged ICU LOS are similar to PMV risk factors, including younger age (OR = 2.3, 95% CI 1.28-4.12, P =.005), lower weight (OR = 2.83, 95% CI 1.58-5, P <.001), underweight status (OR = 1.7, 95% CI 1.12-2.57, P =.012), and residual lesion (OR = 3.79, 95% CI 1.43-10.05, P =.007). Both aortic cross-clamp and cardiopulmonary bypass times did not exhibit clinically significant risk factors toward PMV and prolonged ICU LOS. Conclusions: The risk factors for PMV and prolonged ICU LOS were residual lesion, younger age, and lower weight. Nutritional status contributed to the risk of prolonged ICU LOS, but not PMV. Consideration of these factors may provide optimal care to improve the outcome following TOF corrective surgery. © The Author(s) 2023.

Item Type: Article
Additional Information: Cited by: 1
Uncontrolled Keywords: diuretic agent; dobutamine; epinephrine; hypertensive factor; lactic acid; milrinone; noradrenalin; prostaglandin; adolescent; adult; Article; artificial ventilation; atrial fibrillation; atrioventricular block; blood pressure; body weight; bradycardia; cardiopulmonary bypass time; cerebrovascular accident; child; congenital blood vessel malformation; cross clamp time; Down syndrome; Fallot tetralogy; female; forward heart failure; fraction of inspired oxygen; heart arrhythmia; heart atrium septum defect; heart rate; heart right ventricle double outlet; heart right ventricle outflow tract; heart surgery; heart ventricle fibrillation; heart ventricle septum defect; heart ventricle tachycardia; hospital readmission; human; infant; intensive care unit; intraoperative period; intubation; junctional ectopic tachycardia; kidney failure; length of stay; lesions and defects; major aortopulmonary collateral arteries; male; mortality; newborn; nutritional status; patent ductus arteriosus; patent foramen ovale; positive end expiratory pressure ventilation; postoperative care; postoperative period; preoperative period; prolonged mechanical ventilation; pulmonary hypertension; pulmonary valve insufficiency; pulmonary valve stenosis; residual lesion; retrospective study; right ventricular hypertrophy; risk factor; seizure; sepsis; systemic inflammatory response syndrome; tachycardia; tracheostomy; transesophageal echocardiography; underweight
Subjects: R Medicine > RD Surgical Divisions
Divisions: Faculty of Medicine, Public Health and Nursing > Surgical Divisions
Depositing User: Mukhotib Mukhotib
Date Deposited: 14 Mar 2025 03:09
Last Modified: 14 Mar 2025 03:09
URI: https://ir.lib.ugm.ac.id/id/eprint/15750

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