Predisposing Factors of Postoperative Pulmonary Complication in Children with Congenital Heart Disease

ABSTRACT

PURPOSE: Postoperative care usually required 24-48 hours at intensive care unit (ICU) in children with congenital heart disease. More longer ICU stay may give more chances to produce the postoperative complications. Postoperative pulmonary complication is produced to a much higher incidence after longer immobilized state with keeping catheters and arterial and venous lines. So, we evaluated the predisposing factors those are oriented to ICU stay factors and age, hematologic abnormalities, hepatic dysfunction, infections during ICU care in children with congenital heart disease. METHODS: A retrospective review was performed of postoperative factors for children undergoing open heart surgery in intensive cardiac unit, Wonkwang medical cardiac center. A total of 193 pediatric patients who had cardiac surgery with cardiopulmonary bypass in a 10 year period from Jan. 1995 until Dec. 2004 were reviewed. After logistic regression test, predisposing factors were deemed significant if associated with a pulmonary complication with P<0.05. RESULTS: Children who fell postoperative pulmonary complication in our institution occupied 15% of 193 patients with congenital heart disease. Of all clinical factors considered, those significantly associated with postoperative pulmonary complication were as follows high ALT level, longer duration of mechanical ventilation and arterial line maintenance. CONCLUSION: Prompt weaning of mechanical ventilation and removal of arterial line during ICU stay in children underwent open heart surgery may be necessary to decrease the risks of postoperative pulmonary complication.