FACTORS ASSOCIATED WITH THE OCCURRENCE OF POST-OPERATIVE PULMONARY COMPLICATIONS IN CHILDREN SIX YEARS OLD AND ABOVE WHO UNDERWENT CARDIO THORACIC SURGERY

Abstract

SESSION TITLE: Cardiothoracic Surgery Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: Postoperative pulmonary complications are a major cause of morbidity, mortality, prolonged hospital stay, and increased cost of care. The high incidence of post -operative pulmonary complication after cardiothoracic surgery led to the initiation of this study. Despite pre-operative evaluation and pulmonary risk stratification of patients prior to surgery, it is unfortunate that a lot of them still acquire pulmonary complications hence receive further intervention and stay in the hospital for a longer time. This study aims to identify the the significant preoperative risk factors in the development of post -operative pulmonary complications in children six-year-old and above who underwent cardio thoracic surgery. In addition, this study wants to determine the incidence of post-operative pulmonary complications. METHODS: The study is prospective cohort study that examines the factors associated in predicting post-operative pulmonary complications in children undergoing cardio thoracic surgery. It was implemented in year 2019 and was conducted for a period of 1 year. The study involved patients who are 6-year-old to 18year old who underwent cardio thoracic surgery in the Philippine Heart Center. RESULTS: One hundred fifty patients, were enrolled in the study and a total of 78 patient were noted with complications. The following are the post-operative pulmonary complications: Lobar atelectasis (20.67%); Persistent pleural effusion (18.00%); Pneumonia (17.33%) Pneumothorax not related to chest tube manipulation (12.00 %) and Pulmonary congestion in cardiac conditions of which congestion is not an expected outcome after correction (10.00 %). The pre-operative risk factors found to be significantly associated with post- operative pulmonary complication are 1.) Reduced FVC (P - value 0.016), 2.) Reduced FEF 25-75 (P-value 0.003), 3.) Presence of URTI (P-value 0.001), 4.) Presence of Pulmonary Artery Hypertension on 2D-echo (P-value 0.010). The other variables that were found not to be a significant risk factor in the development of post operative pulmonary complication include patient's age, sex, nutritional status based on WHO and SGNA, medical history of asthma and tuberculosis, ASA physical status, Acid Base Status, Complete Blood count, and chest radiograph prior to procedure. CONCLUSIONS: In this study, the incidence of post -operative pulmonary complication is 52%, with atelectasis as being the most common complication. The four significant pre- operative risk factors are reduced FVC, reduced FEF 25-75, presence of upper respiratory tract infection, and presence of pulmonary arterial hypertension on echocardiography. CLINICAL IMPLICATIONS: Knowledge of the risk factors associated with the development of post- operative pulmonary complication is important in the prevention pulmonary morbidity. DISCLOSURES: No relevant relationships by JENNEYFER REZZA RUCKENBROD, source=Web Response