The Annals of thoracic surgery
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With improvements in the techniques of microvascular surgery, the Blalock-Taussig shunt has been applied to smaller infants. We report our experience in 17 neonates (mean age 9 days, mean weight 3.2 kg) who underwent emergency shung operations. The early mortality was 17.6% (3 of 17), with only 1 death (7%) from renal failure and sepsis, in the last 14 patients. ⋯ The late mortality was high (5 of 14), but was due to late shunt failure and was preventable in only 1 patient. These results are encouraging, and we continue to perform the Blalock-Taussig shung in neonates. It is hoped that improvements in technique will reduce the incidence of inadequate shunts.
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Comparative Study Clinical Trial Controlled Clinical Trial
A comparative study of IPPB, the incentive spirometer, and blow bottles: the prevention of atelectasis following cardiac surgery.
Following cardiac operations, 145 patients were treated with either intermittent positive-pressure breathing (IPPB), blod bottles, or an incentive spirometer in an attempt to alter the incidence of atelectasis. Pulmonary complications occurred in 30% of the patients receiving IPPB, 15% of those using an incentive spirometer, and 8% of those using blow bottles. ⋯ The cost of IPPB is also considerably greater than either incentive spirometry or blow bottles. IPPB is not essential to prevention of atelectasis in postoperative cardiac surgical patients and may be inferior to other methods.