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Factors prolonging length of stay in the cardiac intensive care unit following the arterial switch operation

Published online by Cambridge University Press:  20 December 2007

Derek S. Wheeler ,
Catherine L. Dent ,
Peter B. Manning  and
David P. Nelson
Derek S. Wheeler*
Affiliation:
Divisions of Critical Care Medicine, Cardiology, and Cardiothoracic Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, Departments of Pediatrics and Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States of America
Catherine L. Dent
Affiliation:
Divisions of Critical Care Medicine, Cardiology, and Cardiothoracic Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, Departments of Pediatrics and Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States of America
Peter B. Manning
Affiliation:
Divisions of Critical Care Medicine, Cardiology, and Cardiothoracic Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, Departments of Pediatrics and Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States of America
David P. Nelson
Affiliation:
Divisions of Critical Care Medicine, Cardiology, and Cardiothoracic Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, Departments of Pediatrics and Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States of America
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Abstract

The arterial switch operation has become the preferred procedure for surgical management of transposition, defined on the basis of concordant atrioventricular and discordant ventriculo-arterial connections. We conducted a retrospective evaluation of our experience in 61 infants with this segmental combination, seen from January, 1997, to July, 2003, in order to determine the factors that are associated with a prolonged postoperative course. Factors independently associated with a prolonged postoperative stay in the cardiac intensive care unit included prematurity, difficulty in feeding, capillary leak, need for preoperative inotropic support, and postoperative infectious complications. Future research is warranted designed to minimize the impact of capillary leak and postoperative infectious complications. In addition, based on these results, our practice has evolved to initiate enteral feedings in the preoperative period if feasible, with such enteral feedings resumed as soon as possible following surgery.

Keywords

Transposition of the great arteriescongenital heart diseasetaussig-bing anomalyresidual cardiac abnormalitiespediatric cardiac intensive care
Type
Original Article
Information
Cardiology in the Young , Volume 18 , Issue 1 , February 2008 , pp. 41 - 50
Copyright
Copyright © Cambridge University Press 2008

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