Evaluation of perioperative risk factors in pediatric patients with left ventricle outflow tract obstruction.

IF 0.6 Q4 SURGERY Kardiochirurgia I Torakochirurgia Polska Pub Date : 2023-12-01 Epub Date: 2024-01-11 DOI:10.5114/kitp.2023.134161
Canan Salman Önemli, Kübra Evren Şahin, Mustafa Karaçelik, Çagatay Bilen
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Abstract

Introduction: Left ventricular outflow tract obstructions (LVOTO) presents as complex cardiac diseases accompanied by other cardiac anomalies in the pediatric age group. Postoperative complications, especially cardiac, pulmonary, and renal complications, that may develop after pediatric cardiac surgery can become life-threatening. If the perioperative risk factors for these complications are known in pediatric patients with LVOTO, anesthesiologists and surgeons may take precautions to eliminate undesirable outcomes.

Aim: To evaluate the perioperative risk factors that may contribute to the development of postoperative complications in pediatric patients operated on for LVOTO in a pediatric cardiac surgery clinic.

Material and methods: The study retrospectively investigated 58 patients who were operated on for LVOTO in a pediatric cardiac surgery clinic. The patients were divided into two groups, those with and without postoperative complications. Preoperative laboratory test results, anesthesia time, operation time, aortic cross-clamp time, cardiopulmonary bypass (CPB) time, postoperative inotropes, first postoperative laboratory tests, intraoperative and postoperative complications, mechanical ventilation time, intensive care unit stay, and hospital stay were recorded.

Results: The most common postoperative complications were endocrine complications, followed by hepatic complications. The preoperative lymphocyte count was significantly higher (p < 0.05), and the neutrophil-to-lymphocyte ratio (NLR) was significantly lower (p < 0.05) in the group with postoperative complications. The postoperative pH, glucose, creatinine, and aspartate aminotransferase (AST) levels were significantly lower (p < 0.05), and the postoperative calcium level was significantly higher (p < 0.05) in the group without postoperative complications. Intraoperative platelet transfusion rate was found to be significantly lower (p < 0.05) in the group with postoperative complications.

Conclusions: It is critical to identify predictive factors to prevent postoperative complications in pediatric patients undergoing surgery for LVOTO. Preoperative NLR, intraoperative platelet transfusion, and postoperative calcium, glucose, pH and AST levels may help in the prediction of complications.

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评估左心室流出道梗阻儿科患者围手术期的风险因素。
导言:左心室流出道梗阻(LVOTO)是小儿时期伴有其他心脏畸形的复杂心脏疾病。小儿心脏手术后可能出现术后并发症,尤其是心脏、肺部和肾脏并发症,可危及生命。目的:评估在小儿心脏外科诊所接受左心室瓣膜置换手术的小儿患者术后出现并发症的围手术期风险因素:研究回顾性调查了58名在小儿心脏外科诊所接受左心室开放手术的患者。患者分为两组,即有术后并发症和无术后并发症。记录了术前实验室检查结果、麻醉时间、手术时间、主动脉交叉钳夹时间、心肺旁路(CPB)时间、术后肌力药物、术后首次实验室检查、术中和术后并发症、机械通气时间、重症监护室住院时间和住院时间:最常见的术后并发症是内分泌并发症,其次是肝脏并发症。术前淋巴细胞计数明显高于术后并发症组(P<0.05),中性粒细胞与淋巴细胞比值(NLR)明显低于术后并发症组(P<0.05)。无术后并发症组的术后pH值、血糖、肌酐和天冬氨酸氨基转移酶(AST)水平明显降低(P<0.05),术后血钙水平明显升高(P<0.05)。术后出现并发症组的术中血小板输注率明显降低(P < 0.05):结论:对于接受左心室视网膜缺损手术的儿童患者来说,确定预防术后并发症的预测因素至关重要。术前NLR、术中血小板输注以及术后钙、葡萄糖、pH值和谷草转氨酶水平可能有助于预测并发症。
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来源期刊
CiteScore
0.90
自引率
14.30%
发文量
44
审稿时长
6-12 weeks
期刊介绍: Polish Journal of Thoracic and Cardiovascular Surgery is a quarterly aimed at cardiologists, cardiosurgeons and thoracic surgeons. Includes the original works (experimental, research and development), illustrative and casuistical works about cardiology and cardiosurgery.
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