Emergency surgery for 74 infants with congenital heart disease suffering from severe pneumonia and respiratory failure / 中国小儿急救医学

ABSTRACT

Objective:To analyze the feasibility and efficacy of emergency congenital heart disease(CHD) surgery in infants with CHD suffering from severe pneumonia and respiratory failure.Methods:The clinical data of 74 CHD infants who underwent emergency surgery at Shengjing Hospital of China Medical University from January 2015 to December 2019 due to severe pneumonia and respiratory failure were collected.All patients underwent radical surgery.The perioperative mortality and main complications during hospitalization, as well as the mechanical ventilation time before and after the operation were analyzed.Results:There was no death case during the operation, no secondary thoracotomy.Three patients were discharged from the hospital (4.05%). The incidence of complication of complication was 4.05% (3/74), including 1 case of pericardial effusion (1.35%), 1 patient with pleural effusion (1.35%), and 1 patient with arrhythmia(1.35%). The preoperative mechanical ventilation time was 3-20 days, with an average of (9.41±5.67) days, and the postoperative mechanical ventilation time was 1-9 days, with an average of (4.50±1.96) days.The difference between preoperative and postoperative mechanical ventilation time was statistically significant ( t=2.468, P=0.024). The length of treatment in the ICU was 4-29 days before surgery, with an average of (13.28±6.44) days; the length of stay in the ICU was 7-31 days after surgery, with an average of (16.76±7.89) days.There was no statistically significant difference between the length of stay in the ICU before and after surgery ( t=1.565, P=0.125). Total hospital stay was 13-60 days, with an average of (30.32±11.47) days.The average level of NT-proBNP before operation was (11 053±8 420) pg/ml, and the average level of NT-proBNP decreased to (2 266±2 126) pg/ml after operation ( P<0.05). Conclusion:CHD infants with severe pneumonia and respiratory failure, even if they need ventilator support before surgery, are not a contraindication for primary surgery.Surgery may be an effective method to stop the mechanical ventilation for patients with severe pneumonia.