Risk factors and management strategies for acute respiratory distress syndrome in children after car diopulmonary bypass

Abstract

Objective To analyze the risk factors,prevention and management strategies of acute respiratory distress syndrome(ARDS)after cardiopulmonary bypass(CPB).Methods Between January 2001 and October 2008,1 408 patients undergoing open heart surgery were recruited for study.Univariate and multivariate logistic regression analysis were used to identify the risk factors.Results Thirty-two patients (2.27%)developed ARDS.The mortality for ARDS was 46.9 %(15/32).Univariate risk factors included cyanotic congenital heart disease,CPB lime,aortic cross-clamping time,mechanical ventilation time,the volume of postoperative drainage per kilogram of body weight,perioperative unexpected events and postoperative complications.Multivariate logistic regression analysis showed that CPB time ＞ 180 rain,postoperative drainage volume per kilogram of body weight ＞ 18 ml,perioperative unexpected events,postoperative multiple organ dysfunction syndrome(MODS)were risk factors.Condusion Active and effective treatments should be carried out in the children with high risk factors of ARDS following open heart operation.It would play an important role in the prevention,early diagnosis and management of ARDS. Key words: Cardiopulmonary bypass; Acute respiratory distress syndrome; Risk factors; Children