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Objective To identify the risk factors for early fluid overload (FO) following repair in the pediatric patients with anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) complicated with moderate or severe left ventricular dysfunction (left ventricular ejection fraction [LVEF] ＜50％) and evaluate the effect on clinical outcomes.Methods Forty-three pediatric patients with ALCAPA complicated with moderate or severe left ventricular dysfunction,aged 2-128 months,weighing 4.5-34.5 kg,with New York Heart Association Ⅲ or Ⅳ,undergoing ALCAPA repair,were enrolled in this study.The pediatric patients were divided into FO ≥ 5％ group (n =14) and FO＜5％ group (n =29)according to the FO developed within 24 h after operation.The pediatric Risk,Injury,Failure,Loss,and End-Stage Renal Disease criterion was used to diagnose acute kidney injury developed after operation.Factors including age,height,weight,preoperative LVEF,preoperative biomarkers,operative data,postoperative ventilation time,duration of intensive care unit (ICU) stay and related postoperative clinical outcome parameters were recorded.The risk factors of which P values were less than 0.05 would enter the multivariate logistic regression analysis to stratify the risk factors for FO ≥ 5％ developed within 24 h after operation.The effect of FO≥5％ on postoperative severe acute kidney injury (Injury and Failure),ventilation time,duration of ICU stay and etc.was assessed.Results Fourteen cases developed early postoperative FO≥5％,and the incidence was 33％.The results of the logistic regression analysis showed that lower preoperative LVEF was an independent risk factor for early postoperative FO ≥ 5％ (P＜0.05).Compared with FO＜5％ group,the postoperative ventilation time and duration of ICU stay were significantly prolonged,the number of pediatric patients who developed pulmonary infection and required reintubation was increased,the number of pediatric patients in whom duration of ICU stay was more than 14 days was increased (P＜0.05),and no significant change was found in the other parameters of clinical outcomes in FO ≥ 5％ group (P＞0.05).Conclusion Lower preoperative LVEF is a risk factor for early postoperative FO in pediatric patients with ALCAPA complicated with a moderate or severe left ventricular dysfunction undergoing repair,and it is not helpful for clinical outcomes in pediatric patients when postoperative early FO≥5％ occurs.
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Objective@#To identify the risk factors for early fluid overload(FO)following repair in the pediatric patients with anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) complicated with moderate or severe left ventricular dysfunction (left ventricular ejection fraction [LVEF]<50%) and evaluate the effect on clinical outcomes.@*Methods@#Forty-three pediatric patients with ALCAPA complicated with moderate or severe left ventricular dysfunction, aged 2-128 months, weighing 4.5-34.5 kg, with New York Heart Association Ⅲ or Ⅳ, undergoing ALCAPA repair, were enrolled in this study.The pediatric patients were divided into FO≥5% group (n=14) and FO<5% group (n=29) according to the FO developed within 24 h after operation. The pediatric Risk, Injury, Failure, Loss, and End-Stage Renal Disease criterion was used to diagnose acute kidney injury developed after operation. Factors including age, height, weight, preoperative LVEF, preoperative biomarkers, operative data, postoperative ventilation time, duration of intensive care unit(ICU)stay and related postoperative clinical outcome parameters were recorded.The risk factors of which P values were less than 0.05 would enter the multivariate logistic regression analysis to stratify the risk factors for FO≥5% developed within 24 h after operation.The effect of FO≥5% on postoperative severe acute kidney injury (Injury and Failure), ventilation time, duration of ICU stay and etc. was assessed.@*Results@#Fourteen cases developed early postoperative FO≥5%, and the incidence was 33%.The results of the logistic regression analysis showed that lower preoperative LVEF was an independent risk factor for early postoperative FO≥5% (P<0.05). Compared with FO<5% group, the postoperative ventilation time and duration of ICU stay were significantly prolonged, the number of pediatric patients who developed pulmonary infection and required reintubation was increased, the number of pediatric patients in whom duration of ICU stay was more than 14 days was increased (P<0.05), and no significant change was found in the other parameters of clinical outcomes in FO≥5% group (P>0.05).@*Conclusion@#Lower preoperative LVEF is a risk factor for early postoperative FO in pediatric patients with ALCAPA complicated with a moderate or severe left ventricular dysfunction undergoing repair, and it is not helpful for clinical outcomes in pediatric patients when postoperative early FO≥5% occurs.
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Objective:To research the quality of postoperative recovery of patients with lung cancer through the(PQRS),and compare the recovery quality after video-assisted thoracoscopic surgery (VATS) or traditional open lobectomy.Method:PQRS scale was used to evaluate the recovery of 140 patients with lung lesions preoperatively and postoperative 1 day,3 days,7 days,14 days and 1 month.95 patients who met the set standard and complete the PQRS scales were enrolled and divided into video-assisted thoracoscope group or traditional thoracotomy group.This article mainly compared and analysied the quality of postoperative recovery of patients in both groups.Result:Except the anesthesia time,other general datum showed no statistical difference.In total recovery rate,the video-assisted thoracoscope group has significant difference when compared with the traditional thoracotomy group(P ＜ 0.05).The recovery rates of VATS group in feeling of the harmful factors,emotional factors and the daily life are higher than that of the traditional thoracotomy group,with statistically significant differences(P ＜0.05).However,the recovery rates in the physiological factors and cognitive factors had no statistical difference between two groups(P＞ 0.05).Conclusion:PQRS can effectively evaluate the quality of postoperative recovery in patients with lung cancer,and VATS is helpful to quick recovery postoperatively.