Multifactor Analysis Of Postoperative Mechanical Ventilation Supporting Time In Infant With Congenial Heart Disease

Background: Congenital heart disease has always been an important aspect of the field of cardiovascular. With the continuous development of cardiac surgical techniques, a lot of congenital heart disease in infants can be cured, at the same time, recovery after surgery is the key factor that determines success. To mechanically ventilated children after open heart surgery, so how reasonable to shorten the duration of mechanical ventilation has become a very important thing postoperative recovery in children with vital organ function and stability of the physiological and biochemical indexes. It is not only help to shorten reasonable ventilation, but can also shorten the length of hospital stay in children, reduce the economic burden on individuals and society through research in children before surgery, intraoperative and postoperative cardiopulmonary conditions. In order to understand the relationship between postoperative mechanical ventilation and perioperative factors, it is necessary for children that gender, age, weight, type of disease, aortic clamping time, CPB time aspects, preoperative lung condition, and postoperative complications were analyzed to identify the major factors associated with mechanical ventilation.Objective: With the development of medical technology, many patients with congenital heart disease in infants and young children can get treatment, but little has been done to identify the predictors of PMV in young infants. Summary the data of sex, age, weight, type of disease, aortic clamping time, CPB time, preoperative lung condition, complications, whether they suffered pulmonary hypertension, and whether they used ultrafiltration technology in infant aging less than 3 years old with performed heart surgery, find out risk factors that related to postoperative mechanical ventilation time, and discuss the corresponding treatment measures, improve the quality of recovery after operation.Method: From January 2014 to October 2015, 418 infants with age less than 3 years old from Cardiac surgery of the first hospital of Hebei Medical University undergoing open cardiac surgery in this research. We calculated postoperative ventilation time for each group of risk factors, and analyzed the relationship between 10 peri-operative indexes and the duration of MV. The Multifactor stepwise logistic regression statistics were done for these 10 factors affecting the MV.Result: The MV supporting time was 1.5-264(average 27.66)h. Each risk factor for postoperative ventilation time and Logistic analysis results were as follows: the postoperative ventilation time for complex congenital heart disease group was 51.92 ± 61.91 h, P <0.05; the postoperative ventilation time for age under 6 months group was 38.53 ± 46.35 h, P <0.05; the postoperative ventilation time for weight under 5kg group was 81.76 ± 60.33 h, P <0.05; the postoperative ventilation time for CPB time more than 120 min group was 121.40 ± 77.46 h, P<0.05; the postoperative ventilation time for preoperative pulmonary infection group was 106.35 ± 56.57 h, P <0.05; the postoperative ventilation time for suffering pulmonary hypertension group was 51.26 ± 49.63 h, P<0.05; the postoperative ventilation time for unused ultrafiltration group was 47.12 ± 34.87 h, P<0.05; the postoperative ventilation time for postoperative ventilator-related complications group was 72.36±50.21 h,P<0.05; the postoperative mechanical ventilation time for postoperative non-ventilator-related complications group was 91.42 ± 84.27 h, P<0.05. The Multifactor stepwise logistic regression statistics analysis indicated that the type of disease, age, weight, cardiopulmonary bypass time, postoperative complications, preoperative pulmonary infection, pulmonary hypertension, and modified ultrafiltration were significantly correlated to the ventilation supporting time.Conclusion: The type of disease, age, weight, cardiopulmonary bypass time, postoperative complications, preoperative pulmonary infection all prolong the ventilation supporting time; the modified ultrafiltration during the operation can shorten the ventilation supporting time.