• López-Herce Cid Jesús J Sección de Cuidados Intensivos Pediátricos. Hospital General Universitario Gregorio Marañón. Madrid. España. pielvi@ya.com, Pablo Leyton Avilés, Javier Urbano Villaescusa, Elena Cidoncha Escobar, Jimena Del Castillo Peral, Carrillo Alvarez Angel A, and José María Bellón Cano.
• Sección de Cuidados Intensivos Pediátricos. Hospital General Universitario Gregorio Marañón. Madrid. España. pielvi@ya.com
• Med Intensiva. 2008 Nov 1; 32 (8): 369-77.

ObjectiveTo study the postoperative factors associated with prolonged mechanical ventilation after cardiac surgery in children.DesignProspective observational study.SettingPediatric intensive care unit (PICU).Patients59 children aged between 2 months and 14 years after cardiac surgery.Variables Of InterestWe analyzed postoperative parameters associated to mechanical ventilation lasting more than 3 and more than 7 days. We performed a stepwise multiple logistic regression analysis to study the influence of each factor on prolonged mechanical ventilation.ResultsMechanical ventilation lasted more than 3 days in 19 (32%) children and more than 7 days in 12 (20%). Predictive factors at PICU admission and 24 hours after admission associated with mechanical ventilation at 3 and 7 days were age less than 12 months, weight less than 7 kg, extrapulmonary complications (hypotension, arrhythmias, postoperative bleeding, delayed sternal closure, and airway complications), nitric oxide treatment, midazolam perfusion more than 4 microg/kg/min or fentanyl perfusion more than 4 microg/kg/h, and continuous muscle relaxant treatment. In the logistic multiple regression study, weight less than 7 kg and extrapulmonary complications predicted 82.8% of children with mechanical ventilation more than 3 days and 87.9% with mechanical ventilation more than 7 days.ConclusionsWeight less than 7 kg and extrapulmonary complications are the most important factors associated with prolonged mechanical ventilation after cardiac surgery in children.

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