HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Juan Leon-Wyss Aldo R. Castañeda Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Vida, V. L. Articles by Castañeda, A. R. Search for Related Content PubMed PubMed Citation Articles by Vida, V. L. Articles by Castañeda, A. R. Related Collections Congenital - acyanotic

Ann Thorac Surg 2006;81:1460-1465
© 2006 The Society of Thoracic Surgeons

---

Original article: Cardiovascular

Pulmonary Artery Hypertension: Is It Really a Contraindicating Factor for Early Extubation in Children After Cardiac Surgery?

Pediatric Cardiac Surgery Unit of Guatemala (UNICARP), Guatemala Ciudad, Guatemala

Accepted for publication November 28, 2005.

^_* Address correspondence to Dr Vida, Unidad de Cirugia Cardiovascular de Guatemala (UNICAR), 9 Avenida, 8-00, Zona 11, Guatemala Ciudad, Guatemala (Email: vladimirovida{at}interfree.it).

BACKGROUND: One of the perceived major contraindications to early extubation after pediatric cardiac surgery is preoperative pulmonary arterial hypertension (PAH). The objective of this study is to present the results of early extubation (within 6 hours after open heart surgery) in children who had varying degrees of preoperative pulmonary arterial hypertension.

METHODS: We reviewed the charts of 100 consecutive children who underwent subaortic ventricular septal defect closure and also had preoperative PAH. Outcomes measured included early extubation rate, clinical status of patients, and hospital costs.

RESULTS: The median age at surgery was 2.5 years (range, 0.4 to 30). Sixty-five patients were extubated successfully in the operating room; 25 additional patients were extubated in the intensive care unit within 6 hours from surgery, increasing the early extubation rate from 65% to 90%. Postoperative complications were present in 12 patients; 10 of these patients required mechanical ventilation for more than 6 hours, and 1 of them died postoperatively in septic shock. Two patients required reintubation 25 and 26 hours, respectively, after initial extubation in the operating room, for causes unrelated to pulmonary hypertensive crises or ventilatory failure. The mean cost of procedures in patients who had successful early extubation was US $3,786.50 ± 302.45. Every additional day in the intensive care unit, in case of delayed extubation, increased the overall cost of the procedure by 10%.

CONCLUSIONS: Pulmonary artery hypertension does not seems to be a contraindicating factor to early extubation in patients who underwent ventricular septal defect closure, and may be considered a feasible way to decrese postoperative intensive care unit stay and hospital costs.

This article has been cited by other articles:

				L. A. Larrazabal, K. J. Jenkins, K. Gauvreau, V. L. Vida, O. J. Benavidez, G. A. Gaitan, F. Garcia, and A. R. Castaneda Improvement in Congenital Heart Surgery in a Developing Country: The Guatemalan Experience Circulation, October 23, 2007; 116(17): 1882 - 1887. [Abstract] [Full Text] [PDF]