Influence factors of extubation failure following surgical repair of congenital heart defects in infants

Abstract

Objective To investigate the risk factors of extubation failure following surgical repair of congenital heart defects (CHD) in infants. Methods Infantile patients who underwent surgical repair of CHD under cardio-pulmonary bypass (CPB) in the First Affiliated Hospital of Sun Yat-Sen University from January 2015 to October 2016 were included.According to results of extubation, the patients were divided into the extubation failure group and extubation success group.Clinical and laboratory data were collected and analyzed, including age, gender, body mass, the types of congenital heart disease, extracorporeal circulation time and the use of vasoactive drug, et al. Results Sixty cases were enrolled in this study.Among them 12 cases (7 males, 5 females with the boy to girl ratio of 1.4∶1.0, and average age was 0.56 years old) were in the extubation failure group, in which 3 cases (25.0%) aged 5-10 kg.Forty-eight cases(27 males, 21 females; the boy to girl ratio was 1.2∶1.0 and average age was 1.15 years old) were in the extubation success group.The distribution of age and body weight were significantly lower in the extubation failure group than those in the extubation success group[0.42 (0.37) years old vs.1.00 (1.08) years old, Z=-3.22, P 0.05). Multiple Logistic regression showed that the duration of CPB was an independent risk factor of extubation failure[odds ratio (OR)=0.967, 95% CI: 0.956-0.997, P=0.024]. Conclusions The risk factors of extubation failure include young age, low body weight, and prolonged CPB and mechanical ventilation.CPB time is an independent risk factor of extubation failure following cardiac surgery in infants. Key words: Infant; Congenital heart disease; Postoperative; Extubation failure; Risk factor