Risk factors for delayed extubation after radical surgery in children with tetralogy of Fallot

Zhu Yan; Fan Xing; Zhang Tingzhou; Gu Hong; He Yan

doi:10.3760/j.issn.1673-4777.2024.06.018

Abstract：Objective To analyze the risk factors for delayed extubation after radical surgery in children with tetralogy of Fallot(TOF).Methods A total of 287 children diagnosed with TOF in the Pediatric Heart Center,Beijing Anzhen Hospital,Capital Medical University from January 2018 to December 2021 were enrolled in this study.Based on whether mechanical ventilation time was greater than or equal the median(49 h),they were divided into normal extubation group(144 cases)and delayed extubation group(143 cases).The perioperative clinical data of the two groups were collected for comparative analysis,to explore the single factor affecting the duration of mechanical ventilation,and then multivariate Logistic regression analysis was performed.Results All children underwent radical surgery,and the median mechanical ventilation time was 49(24,93)h.The age,body mass,body surface area,preoperative blood oxygen saturation,Mcgoon ratio,pulmonary artery index measured by ultrasound,proportion of preoperative lateral branch occlusion,proportion of cross valve ring patch surgery,cardiopulmonary bypass time,ascending aorta occlusion time,length of intensive care unit hospital stay,proportion of postoperative capillary leakage syndrome(CLS),and the proportion of serious adverse events in two groups after surgery showed statistically significant differences(all P＜0.05).Multivariate Logistic regression analysis showed that preoperative lateral branch occlusion(odds ratio=2.896),postoperative CLS(odds ratio=6.610),cross valve ring patch surgery(odds ratio=1.800),and lower body mass(odds ratio=0.959)were independent risk factors for postoperative delayed extubation in children with TOF(all P＜0.05).Conclusion Preoperative lateral branch occlusion,postoperative CLS,cross valve ring patch surgery and lower body mass are independent risk factors for postoperative delayed extubation in children with TOF.