ГБОУ ВПО ВГМУ МИНЗДРАВСОЦРАЗВИТИЯ РОССИИ КАФЕДРА ИНОСТРАННЫХ ЯЗЫКОВ High-frequency oscillatory ventilation and short- term outcome in neonates and infants.

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Presentation transcript:

ГБОУ ВПО ВГМУ МИНЗДРАВСОЦРАЗВИТИЯ РОССИИ КАФЕДРА ИНОСТРАННЫХ ЯЗЫКОВ High-frequency oscillatory ventilation and short- term outcome in neonates and infants undergoing cardiac surgery. Выполнила: студентка 201 группы педиатрического факультета Юринок О.С. Проверил: ст. преподаватель Огородникова Э.Ю.

Actuality Thought to be beneficial upon gas exchange and pulmonary vascular resistance have used HFOV in infants with respiratory distress following cardiac surgery.

Aim The aim of the present study is to assess associations between commencement of HFOV and length of mechanical ventilation, length of intensive care unit stay and mortality in this population.

Materials and methods This retrospective cohort study was conducted at the Necker University Hospital in Paris, France. Surgical and cardiopulmonary bypass (CPB) techniques; extracorporeal membrane oxygenation (ECMO); renal replacement therapy (RRT); mechanical ventilation.

Results Overall 3549 neonates and infants with cardiac surgery were retrospectively enrolled: 4 patients with obstructed total anomalous pulmonary venous connection 1 patient with severe pulmonary hypoplasia, with hopeless prognosis secondary to pulmonary lymphangienctasia. 2 patients died periprocedural

Table 1 - Characteristics of patients switched to high frequency oscillation on the day of surgery HFOV group (n=120) Before matching Overall controls (n=3422) P value 3 After matching CMV group (n=120) P value b Age (days) Weight (kg) < Surgery with cardiopulmonary bypass, n (%) 109 (90.8)2560 (74.8) < (91.7)0.80 Duration of cardiopulmonary bypass (min) < Aristotle score , 6-10<

Figure 1. Number of neonates and infants who underwent surgery during the study period.

Figure 2. Length of mechanical ventilation and Intensive Care Unit stay across the study period.

Table 2 - Most prevalent procedures in the matched set, along with the "HFOV index" of each procedure Most prevalent proceduresHFOV group (n=120) CMV group (n=120) "HFOV index " a Unrestrictive VSD repair Aortic arch repair Arterial switch operation, VSD repair Arterial switch operation Norwood operation Coarctation repair Arterial switch operation, VSD, coarctation repair

Table 3 - Estimates and standard errors for variables included in the propensity score model VariableCoefficient estimate Standar ted erro r Va lu e The "HFOV index" a <0.001 Age (days) Weight (kg) Surgery with cardiopulmonary bypass Acute kidney injury requiring renal replacement therapy Requirement for renal replacement therapy on the day of surgery

Figure 3. Kaplan-Meier plots of the probability of successful weaning over time for each ventilation group.

Conclusions When commenced on the day of surgery, HFOV was associated with a shorter duration of mechanical ventilation and ICU stay in this population of neonates and infants with respiratory distress following congenital heart surgery. No association was observed between HFOV and mortality.