Clinical characteristics of perioperative pneumonia in neonates and young infants with congenital heart diseases

Abstract

Objective To summarize the clinical characteristies of perioperative pneumonia in neonates and young infants with congenital heart diseases(CHD).Methods Between Oct 2006 and Sept 2009,309 neonates and infants with the weight less than 5 kg or age younger than 3 months,were admitted in this center.Of the 309 patients,196 were male and 113 female;206 patients had ventricular septal defect,126 had atrial septal defect,18 had patent ductus arteriosus,160 had moderate to severe pulmonary arterial hypertension,37 had complete transposition of great arteries.11 had pulmonary artery atresia,9 had total anomalous pulmonary venous connection,7 had complete atrial ventricular septal defect.5 had interruption of aortic arch and 5 had double outlet right ventricle.The diagnosis of perioperative pneumonia were made based on symptoms and signs of respiratory tract,temperature,oxygenation index,count of white blood cells and radiographies.Results The morbidity of perioperative pneumonia was 58.9%(182/309)and mortality was 7.1%(13/182).The average length of mechanical ventilation was 47.4±38.0 hours and ICU stay was 5.2±4.1 days.The risk factors correlated to the pneumonia were prematurity,malnutrition,infection history,pulmonary arterial hypertension,complex CHD,emergency surgery,long circulation blocking time,delayed chest closure,hypoxemia after operation,atelectasis,pneumothorax or pleural effusion,re-intubation and long intubation time.Conclusions Perioperative pneumonia is a common complication in neonates and young infants with CHD.The prognosis can be improved by early diagnosis,early cardiac surgery,and comprehensive treatment before and after operation. Key words: Infant,newborn; Heart disease,congenital; Cardiac surgery; Pneumonia