• Paediatric anaesthesia · Jun 2016

    Incidence and risk factors for postoperative vomiting following atrial septal defect repair in children.

    • Joshua Lee, David Faraoni, Sandra Lee, Morgan Brown, Kirsten Odegard, Adrienne Randolph, James A DiNardo, and Koichi Yuki.
    • Department of Anesthesiology, Perioperative and Pain Medicine, Cardiac Anesthesia Division, Boston Children's Hospital, Boston, MA, USA.
    • Paediatr Anaesth. 2016 Jun 1; 26 (6): 644-8.

    BackgroundThe incidence and risk factors for postoperative vomiting (POV) after pediatric cardiac surgery has not been studied.AimsThis study sought to assess the incidence and risk factors for POV in children undergoing surgical repair of an atrial septal defect (ASD).MethodsWe retrospectively collected perioperative data from 160 patients who underwent surgical repair of an ASD and met early extubation criteria. Demographic and clinical data that could potentially influence the incidence of POV were collected. Univariate analysis was performed using Student t-test or Wilcoxon rank test to identify factors associated with POV. Continuous variables were dichotomized based on the cutoff values derived from the receiver operating characteristic (ROC) curve analysis and the Youden-J index. We used multivariate logistic regression analysis using backward selection to determine the independent predictors using a univariate cutoff of P < 0.10 for inclusion and P > 0.05 for removal to determine factors independently associated with POV. The accuracy of our multivariate model was assessed by the area under the ROC curve (AUC).ResultsOverall the incidence of POV was 37.5% in all the children who underwent surgical ASD repair. POV did not significantly differ between patients who received and did not receive antiemetics intraoperatively. Age of ≥4 years and cardiopulmonary bypass (CPB) time ≥51 min were identified as independent risk predictors for POV and the AUC of logistic regression model was 0.650 (95% confidence interval; 0.565-0.735).ConclusionsThe incidence of POV in children undergoing surgical ASD repair was 37.5%. Age ≥4 years and CPB time ≥51 min were identified as independent predictors.© 2016 John Wiley & Sons Ltd.

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