Analysis of the Use of Non-Invasive Lung Ventilation Support in Newborns and Young Children after Cardiac Surgery

Olena O. Yakimishen, Olena I. Tsymbal, Serhii M. Boiko, Iaroslav P. Truba
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Abstract

Background. Non-invasive ventilatory support for artificial lung ventilation (ALV) in infants with congenital heart disease after cardiac surgery helps to reduce the duration of invasive ALV, reduce the number of mechanical and infectious complications, and reduce or eliminate the need for sedation. The aim. To analyze the experience of using non-invasive ventilatory support after surgical correction of congenital heart disease in infants and compare its effectiveness with invasive mechanical ventilation. Materials and methods. We conducted a retrospective analysis of the use of non-invasive ALV and its effectiveness compared to invasive mechanical ventilation in children under 1 year of age after cardiac surgery from 2020 to 2022 at the Department of Cardiac Arrest in Newborns and Young Children of the National Amosov Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine. During this period, 134 patients were operated on (38 children under 1 month old, 96 children under 1 year old). In the postoperative period, 85 children (55.9%) needed prolonged mechanical ventilation (more than 24 hours), of which non-invasive ventilation support was used in 32 patients (37.6%) and invasive ventilation in 53 (62.3%) patients. Results. The patients on non-invasive ALV (n = 32) had lower weight (p = 0.23), shorter ventilation time (p = 0.56), and the time spent at the intensive care unit (p = 0.61), required less sedation (p = 0.29), and had lower mortality (p = 0.42) compared to the group of children who received only invasive ventilatory support (n = 53), but this difference was not statistically significant. The need for non-invasive ventilation was higher in 9 (28.12%) infants than in 8 (15.09%) other infants and was statistically significant (p < 0.001). Conclusions. Our study showed that the use of non-invasive ALV can shorten the length of stay at the intensive care unit and the time spent on ventilation, reduce or avoid the use of sedation, and prevent pulmonary complications (infectious and mechanical) with long-term treatment. However, there was no significant difference between non-invasive and invasive ventilation in terms of mortality.
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新生儿和幼儿心脏手术后无创肺通气支持的应用分析
背景。先天性心脏病患儿心脏手术后人工肺通气(ALV)的无创通气支持有助于缩短有创ALV持续时间,减少机械性和感染性并发症的发生,减少或消除镇静的需要。 的目标。分析婴儿先天性心脏病手术矫治后应用无创通气支持的经验,并与有创机械通气效果比较。 材料和方法。我们在乌克兰国家医学科学院国家阿莫索夫心血管外科研究所新生儿和幼儿心脏骤停科对2020年至2022年1岁以下心脏手术后儿童使用无创ALV及其与有创机械通气的有效性进行了回顾性分析。本组共手术134例,其中1月龄以下患儿38例,1岁以下患儿96例。术后85例(55.9%)患儿需要延长机械通气时间(超过24小时),其中32例(37.6%)患儿采用无创通气支持,53例(62.3%)患儿采用有创通气;结果。无创ALV组(n = 32)与仅接受有创通气支持组(n = 53)相比,体重(p = 0.23)、通气时间(p = 0.56)、重症监护病房时间(p = 0.61)、镇静需求(p = 0.29)和死亡率(p = 0.42)均较低,但差异无统计学意义。9例患儿(28.12%)比8例患儿(15.09%)需要无创通气,差异有统计学意义(p <0.001)强生# x0D;结论。我们的研究表明,使用无创ALV可以缩短重症监护病房的住院时间和通气时间,减少或避免镇静的使用,并预防长期治疗的肺部并发症(感染性和机械性)。无创通气与有创通气的死亡率无显著性差异。
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CiteScore
0.20
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0.00%
发文量
42
审稿时长
6 weeks
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