• A. Marc Harrison, Amy C. Cox, Steve Davis, Marion Piedmonte, Jonathan J. Drummond-Webb, and Roger B. B. Mee.
• Departments of Pediatric Critical Care Medicine (AMH, SD), General Pediatrics, Biostatistics and Epidemiology, and Cardiology and Congenital Heart Surgery (JJDW, RBBM), Division of Pediatrics, Cleveland Clinic Children's Hospital, Cleveland, OH.
• Pediatr Crit Care Me. 2002 Apr 1; 3 (2): 148-152.

Background: Most children who undergo congenital heart surgery require postoperative mechanical ventilation. Failed extubation (FE) may result in physiologic instability, delay, or set back of the weaning process. FE is statistically associated with prolonged mechanical ventilation. Purpose: We sought to identify frequency, pathogenesis, and risk factors for FE after congenital heart surgery in young children. SETTING: Pediatric intensive care unit. PATIENTS: Children ResultsA total of 212 children ConclusionsExtubation fails after approximately 10% of congenital heart surgery in young patients. Causes of FE are diverse. In our population, preoperative pulmonary hypertension, presence of a congenital syndrome, and intraoperative circulatory arrest are risk factors for FE. Prospective validation of our predictive model with larger numbers and at multiple institutions would improve its utility.

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