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首页> 外文期刊>Pediatric critical care medicine: a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies >Early postoperative outcomes in a series of infants with hypoplastic left heart syndrome undergoing stage I palliation operation with either modified Blalock-Taussig shunt or right ventricle to pulmonary artery conduit.
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Early postoperative outcomes in a series of infants with hypoplastic left heart syndrome undergoing stage I palliation operation with either modified Blalock-Taussig shunt or right ventricle to pulmonary artery conduit.

机译：接受改良Blalock-Taussig分流术或右心室至肺动脉导管的I期缓解手术的一系列发育不良的左心综合征婴儿的早期术后结果。

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OBJECTIVE: Previous publications using nonconcurrent series of patients indicate improved survival for patients with hypoplastic left heart syndrome (HLHS) undergoing stage I palliation with a right ventricle to pulmonary artery conduit (NW-RVPA) vs. a modified Blalock-Taussig shunt (NW-BT). We compared postoperative outcomes in a concurrent series of patients with HLHS undergoing an NW-BT procedure vs. NW-RVPA procedure. DESIGN: Perioperative data from 66 consecutive patients who underwent NW-BT (n = 37) or NW-RVPA (n = 29) procedures were retrospectively analyzed. SETTING: Cardiac intensive care unit in a tertiary pediatric hospital. PATIENTS: Charts were reviewed for all patients with the diagnosis of HLHS undergoing the NW-BT or NW-RVPA procedure between January 2002 and December 2003. RESULTS: Cardiopulmonary bypass time was longer in the NW-BT group than in the NW-RVPA group (152.5 +/- 52.0 vs. 134.5 +/- 36.1 mins; p = .04). Postoperative diastolic pressures were higher and the Pao2 to Fio2 ratioprofiles were lower for the NW-RVPA group over the first 72 hrs. Time to sternal closure (2 [1-6] vs. 4 [2-41] days; p = .01), duration of mechanical ventilation (113 [49-386] vs. 136 [84-764] hrs; p = .01), time to establish enteral feeds (4 [2-8] vs. 5 [3-22] days; p = .01), length of intensive care unit stay (11 [7-55] vs. 15 [8-90] days; p = .04), and length of hospital stay (16 [11-67] vs. 27 [12-126] days; p = .01) were shorter in the NW-RVPA group. Postoperative mortality was not significantly different between the NW-RVPA group (7%) and NW-BT group (11%). CONCLUSION: At an experienced institution with low stage I palliation mortality for HLHS, there were no differences in early morbidity and mortality between the NW-RVPA and NW-BT procedures. The primary advantage of the NW-RVPA procedure may be faster recovery following surgery and earlier discharge from the hospital.
机译：目的：以前使用非同期患者系列的出版物表明，与改良的Blalock-Taussig分流器（NW-）相比，接受右心室至肺动脉导管（NW-RVPA）I期缓解的发育不良性左心综合征（HLHS）患者的生存期得到改善BT）。我们比较了一系列同时接受NW-BT手术和NW-RVPA手术的HLHS患者的术后结局。设计：回顾性分析了66例连续接受NW-BT（n = 37）或NW-RVPA（n = 29）手术的患者的围手术期数据。地点：三级儿科医院的心脏重症监护室。患者：回顾了2002年1月至2003年12月期间所有接受NW-BT或NW-RVPA程序诊断为HLHS的患者的图表。结果：NW-BT组的心肺旁路时间比NW-RVPA组更长（152.5 +/- 52.0分钟与134.5 +/- 36.1分钟; p = .04）。 NW-RVPA组在最初的72小时内，术后舒张压较高，Pao2与Fio2的比例曲线较低。胸骨闭合的时间（2 [1-6] vs. 4 [2-41]天; p = 0.01），机械通气时间（113 [49-386] vs. 136 [84-764] hrs; p = .01），建立肠内喂养的时间（4 [2-8]比5 [3-22]天; p = .01），重症监护病房住院时间（11 [7-55]比15 [8] -90天; p = .04），而在NW-RVPA组中，住院时间（16 [11-67]天vs. 27 [12-126]天; p = 0.01）较短。 NW-RVPA组（7％）和NW-BT组（11％）之间的术后死亡率无显着差异。结论：在一个经验丰富的机构中，HLHS的I期减轻死亡率较低，NW-RVPA和NW-BT程序的早期发病率和死亡率没有差异。 NW-RVPA程序的主要优点是手术后恢复更快，出院更早。

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