Pulmonary risk factors compromising postoperative recovery after surgical repair for congenital heart disease

objectives: To identify pulmonary risk factors associated with prolonged IC U stay in young children (less than or equal to 2 years) undergoing surgica l I repair for congenital heart disease (CHD), Design: Retrospective case series analysis. Setting: Tertialy-care facility, Patients: Clinical records of 134 consecutive, patients aged less than or e qual to 2 years undergoing cardiac surgery for CHD were reviewed, and 37 we re excluded according to inclusion criteria. Thus, 97 patients were allocat ed to two groups based on the duration of ICU stay: less than or equal to 7 dais (group 1, n = 57), and > 7 days (group 2, n = 40), Results: Mean ICU duration for groups 1 and 2 was 3.0 +/- 0.4 days and 28.1 +/- 4.4 days, respectively (p < 0,001), In group 1, there were three extub ation failures, whereas 11 extubation failures occurred in group 2 (p < 0,0 .0001), A total of 22 patients (4 in group 1 and 18 in gl group 2) develope d noninfectious pulmonary complications, such as airway, problems, includin g extrinsic airway compression and tracheobronchomal, (n = 6); pulmonary hy pertension (n = 5); phrenic nerve palsy (n = 7); and pleural effusion (n = 8), These 22 patients (23%) contributed to the majority of total ventilator days (67%) as well as ICU stay (61%). Conclusions: Pulmonary complications in general, and central airway problem s in particular, are a frequent cause for delayed recovery following cardia c surgery in young children.