AI Article Synopsis
- Delayed sternal closure in pediatric cardiac surgery is proposed to improve patient outcomes compared to emergency reopening in the ICU for those with unstable hemodynamics.
- A retrospective analysis revealed that 10.42% of patients had their sternums left open post-surgery, with a significantly higher mortality rate (71.42%) for those reopened in the ICU versus those left open from the operating theater (11.16%).
- The study suggests that electively keeping the sternum open in patients with uncertain hemodynamics leads to better survival rates than resorting to emergency procedures.
Article Abstract
Introduction: Delayed sternal closure is used in paediatric cardiac surgery as a management strategy for patients with unstable hemodynamics or postoperative bleeding routinely. We hypothesise that planned postponement of sternal closure leads to better outcomes than emergent reopening in the intensive care unit (ICU) in patients exhibiting some hemodynamic indication for the same.
Methods: We retrospectively analysed the outcomes of delayed sternal closure 220/2111 (10.42%) out of which 14 sternums were opened in the ICU after shifting the patients.
Results: A total of 220/2111 (10.42%) sternums were left open postoperatively, out of which 14 were opened after shifting to the ICU. Total mortality of the delayed sternal closure was 33/220, i.e. 15%. The patients whose sternums were left open from the theatre had a mortality of 23/206, i.e. 11.16%, whereas those patients whose sternums were opened in the ICU had a mortality of 10/14, i.e. 71.42%.
Conclusion: In doubtful postoperatively hemodynamic, the choice of leaving the sternum open electively has better outcomes, rather than opening the sternum as a terminal bail out procedure.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7525374 | PMC |
| http://dx.doi.org/10.1007/s12055-019-00830-1 | DOI Listing |
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