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Onur T, Karaca Ü, Onur A, Engin M, Demirel A, Sayan HE, Özgünay ŞE, Kılıçarslan N, Seçici S, Yirtimci S. Factors affecting extubating time of postoperative patients who underwent congenital cardiac surgery: a randomized prospective study. Eur Rev Med Pharmacol Sci 2023; 27:763-772. [PMID: 36734732 DOI: 10.26355/eurrev_202301_31079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Anesthesia management in pediatric cardiac surgery using health resources sparingly focuses on reducing morbidity and mortality and increasing patients' quality of life. The duration of postoperative mechanical ventilation (MV) heavily influences pediatric cardiac surgery recovery. Thus, in this study we aimed to determine factors influencing extubation times after pediatric cardiac surgery. PATIENTS AND METHODS A total of 72 pediatric patients with an ASA score of III or above undergoing cardiac surgery were included in the study. As a result of their extubation time, the patients were divided into three groups as follows: those who were extubated immediately after surgery or in the operating room (OR) were recorded as Immediate Extubators (IE); those who were extubated within 6 to 48 hours of entering the intensive care unit were recorded as Early Extubators (EE), and those who were extubated after 48 hours or not extubated were recorded as Delayed Extubators (DE). RESULTS A logistic regression analysis showed that anomalies and need of MV before surgery, airway difficulty, and prolonged cross-clamp (CC) time were observed as factors affecting DE. The risk of DE was significantly correlated with the presence of abnormality [Odds ratio (OR): 20.3, 95% Confident interval (CI): 2.8-142.7], with the need of MV before surgery (OR: 1,844, 95% CI: 1.8-1,790,461.9), and with the presence of airway difficulty (OR: 44.7, 95% CI: 4.4-445.0). In addition, it was determined that CC time increased the probability of DE 1.038 times per minute (95% CI: 1.004-1.072). CONCLUSIONS Early and immediate extubation in children who underwent congenital heart surgery was successfully performed in our clinic. Early and immediate extubation in pediatric cardiac surgery can be completed safely and successfully when suitable conditions are provided.
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Affiliation(s)
- T Onur
- Department of Anesthesiology and Reanimation, Department of Cardiovascular Surgery, University of Health Sciences Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey.
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Erek E, Yalçınbaş YK, Sarıosmanoğlu N, Özkan M, Yıldız O, Şenkaya I, Özdemir F, Biçer M, Sarıtaş AB, Atay Y, Seçici S, Kutsal A, Haydin S, Bilen C, Onan IS, Tuncer ON, Citoglu G, Doğan A, Turkoz R, Temur B, Koc M, Sarıoğlu CT. First Harvest of Pediatric and Congenital Heart Surgery Multicenter Database in Turkey: Novel Application of Real-Time Online Reporting. World J Pediatr Congenit Heart Surg 2021; 12:377-386. [PMID: 33942691 DOI: 10.1177/2150135121995474] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES A new congenital heart surgery database (CKCV) with real-time online reporting function was recently developed in Turkey. All standard international parameters were used, but Aristotle Comprehensive Complexity score was modified. In this study, the first analysis of the CKCV Database is reported. METHODS The CKCV Database included 2307 procedures from 12 centers between January 2018 and March 2020. All parameters, including 10 real-time online reports, which represent the number of centers, number and mortality rates of all procedures, number of extracorporeal membrane oxygenation (ECMO) and results, details of postoperative complications, age-group statistics, analysis for priority status, mean intensive care and hospital stay durations of the procedures, results of Aristotle Basic, Modified Aristotle Comprehensive (MACC) and Society of Thoracic Surgeons-European Association (STAT) Score Categories, comparison of centers were analyzed. RESULTS Most common 10 procedures were ventricular septal defect (VSD) repair (n = 273), tetralogy of Fallot (TOF) repair (n = 243), atrial septal defect (ASD) repair (n = 181), complete AVSD repair (n = 95), cavopulmonary anastomosis (n = 81), systemic to pulmonary shunt (n = 79), modified Fontan (n = 71), subaortic resection, (n = 66) PA banding (n = 66), and arterial switch operation (n = 66). Cardiopulmonary bypass was used in 84.6% of the procedures. Overall mortality rate was 6.0%. A total of 618 major and 570 minor complications were observed in 333 and 412 patients, respectively. According to six MACC categories, number of the patients and mortality rates were I (293; 0.3%); II (713; 1.4%); III (601; 3.3%); IV (607; 12%); V (84; 35.7%); and VI (9; 55.6%), respectively. Analysis of five STAT Categories showed 0.7, 3.8, 5.4, 14.9, and 54.7% mortality rates. CONCLUSIONS CKCV Database has a great potential for nationwide quality improvement studies. Users could instantly analyze and compare their results to national and international aggregate data using a real-time online reporting function. This is the first multicenter congenital database study in Turkey.
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Affiliation(s)
- Ersin Erek
- Acibadem Mehmet Ali Aydinlar University, School of Medicine, Atakent Hospital, Istanbul, Turkey.,Children Heart Foundation, Istanbul, Turkey
| | - Yusuf Kenan Yalçınbaş
- Children Heart Foundation, Istanbul, Turkey.,Acibadem Bakirkoy Hospital, Istanbul, Turkey
| | - Nejat Sarıosmanoğlu
- Health Sciences University, Dr. Behçet Uz Training and Research Hospital, Izmir
| | - Murat Özkan
- Başkent University, Ankara Hospital, Ankara, Turkey
| | - Okan Yıldız
- Health Sciences University, Istanbul Mehmet Akif Ersoy Training and Research Hospital, Istanbul, Turkey
| | | | - Fatih Özdemir
- Health Sciences University, Diyarbakır Gazi Yasargil Training and Research Hospital, Diyarbakır, Turkey
| | - Mehmet Biçer
- Health Sciences University, Erzurum Training and Research Hospital, Erzurum, Turkey
| | | | | | | | - Ali Kutsal
- Health Sciences University, Dr. Sami Ulus Training and Research Hospital, Ankara, Turkey
| | - Sertac Haydin
- Health Sciences University, Istanbul Mehmet Akif Ersoy Training and Research Hospital, Istanbul, Turkey
| | - Cagatay Bilen
- Health Sciences University, Dr. Behçet Uz Training and Research Hospital, Izmir
| | - Ismihan Selen Onan
- Health Sciences University, Istanbul Mehmet Akif Ersoy Training and Research Hospital, Istanbul, Turkey
| | | | | | | | - Riza Turkoz
- Acibadem Bakirkoy Hospital, Istanbul, Turkey
| | - Bahar Temur
- Acibadem Mehmet Ali Aydinlar University, School of Medicine, Atakent Hospital, Istanbul, Turkey
| | - Murat Koc
- Health Sciences University, Dr. Sami Ulus Training and Research Hospital, Ankara, Turkey
| | - C Tayyar Sarıoğlu
- Acibadem Mehmet Ali Aydinlar University, School of Medicine, Atakent Hospital, Istanbul, Turkey.,Children Heart Foundation, Istanbul, Turkey.,Acibadem Bakirkoy Hospital, Istanbul, Turkey
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