Introduction: Following congenital heart surgery, pediatric patients may experience persistent respiratory failure that requires tracheostomy placement. Currently, definitive knowledge of the optimal timing for tracheostomy placement in this patient population is lacking.
Methods: An 8-year retrospective review of 17 pediatric patients who underwent congenital heart surgery and subsequently required tracheostomy placement was performed. Patients were evaluated with regard to the timing of tracheostomy and mortality.
Results: The overall study mortality was 24%. The median duration of intubation prior to tracheostomy was 60 days (interquartile range: 19-90 days); there was no difference in the average time between intubation and tracheostomy for survivors compared with nonsurvivors (51 vs. 73 days, P = .37). No difference was observed in the overall duration of positive pressure ventilation when tracheostomy was performed within 30 days of intubation compared with greater than 30 days following intubation (481 vs. 451 days, P = .88). Overall, 18% of patients were successfully weaned from the ventilator after a median duration of positive pressure ventilation of 212 days.
Conclusion: The timing of tracheostomy placement may be an important factor in clinical outcomes for pediatric patients with persistent dependence on mechanical ventilatory support following congenital heart surgery. A larger, multi-institution study may help further elucidate our observed clinical findings in this patient population.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/chd.12192 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Impact of Heart Transplant Allocation Changes on Waitlist Mortality and Clinical Practice in Pediatric and Adult Patients With Congenital Heart Disease and Cardiomyopathy.
Circulation
January 2025
Division of Cardiology, Children's Hospital of Philadelphia and Department of Pediatrics (L.W., M.J.O., H.A., J.E., K.Y.L., C.W.-W., J.R., J.B.E.), University of Pennsylvania, Philadelphia.
Background: The United Network of Organ Sharing made changes to the priority for allocation of hearts for transplantation (HT) in 2016 for pediatric patients and 2018 for adult patients. Although recent work has evaluated the impact of the revised allocation systems on mechanical circulatory support practices and waitlist outcomes, there are limited data that focus more specifically on the impact of the allocation changes on patients with congenital heart disease (CHD) or cardiomyopathy and how these relationships might differ in pediatric and adult patients.
Methods: The United Network of Organ Sharing database was queried for pediatric (<18 years of age) and adult (18-50 years of age) patients with a CHD or cardiomyopathy diagnosis listed for HT.
Options for pediatric heart valve replacement.
Future Cardiol
January 2025
Department of Cardiovascular Surgery, Arkansas Children's Hospital, Little Rock, AR, USA.
Heart valve replacement is indicated for children with irreparable heart valve disease. These replacements come in a variety of forms including mechanical, xenograft tissue, allograft tissue, and autograft tissue valves. These options each have unique benefits and risks profiles.
View Article and Find Full Text PDFAssociation between maternal folic acid and/or multivitamin supplementation time and fetal congenital heart disease: based on the China birth cohort study.
Int J Med Sci
January 2025
Department of Ultrasound, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital. Beijing 100026, China.
A multitude of studies have presented inconsistent outcomes regarding the association between maternal folic acid (FA) and/or multivitamin (MV) supplementation and congenital heart disease (CHD) in offspring. This study aimed to estimate supplementation time and CHD based on a prospective China birth cohort study (CBCS). In the CBCS, 114,670 singleton pregnant women who had pregnancy outcomes until August 2021 and responded to the early pregnancy questionnaire were recruited.
View Article and Find Full Text PDFProvision of continuous renal replacement therapy in children in intensive care in Australia and New Zealand.
Crit Care Resusc
December 2024
Paediatric Critical Care Research Group, Child Health Research Centre, The University of Queensland, South Brisbane, QLD, Australia.
Objectives: The objective of this study was to describe current use, clinical practice, and outcomes of continuous renal replacement therapy (CRRT) in children in the intensive care unit (ICU) in Australia and New Zealand.
Design: retrospective, binational registry-based cohort study and electronic survey of clinical practice.
Setting: ICUs that contribute to the Australian and New Zealand Paediatric Intensive Care Registry and a survey conducted in November 2021 including ICUs accredited for paediatric intensive care training that provide CRRT for children were part of this study.
Continuous frusemide infusion versus intermittent bolus therapy in paediatric intensive care: A single centre retrospective study.
Crit Care Resusc
December 2024
Paediatric Intensive Care Unit, Royal Children's Hospital, Melbourne, VIC, Australia.
Objective: Frusemide is a common diuretic administered to critically ill children intravenously, by either continuous infusion (CI) or intermittent bolus (IB). We aim to describe the characteristics of children who receive intravenous frusemide, patterns of use, and incidence of acute kidney injury (AKI), and to investigate factors associated with commencing CI.
Design: Retrospective observational study.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!