THE RISK FACTORS FOR POSTOPERATIVE OUTCOMES IN NEONATAL CARDIAC SURGERY

Abstract

ABSTRACT Background: In the last three decades a neonatal cardiac surgery has improved the approach and methods for adequate treatment of complex congenital heart defects. Although we have advances in fetal cardiac imaging and improved perioperative cardiac procedures, the postoperative outcomes in neonatal care (neonates) are still present. Objective: To present our experience of operated neonates with congenital heart defects in a tertiary referral center, Neonatal Intensive Care Unit (NICU) in Skopje N. Macedonia. Materials and methods: We conducted a retrospective study including neonates who underwent surgical intervention between January 2013 and December 2015 at the University Clinic for Pediatric Diseases in Skopje. We analyzed perioperative and postoperative variables. The main outcomes were duration of cardiopulmonaly bypass (CPB), and x-cross of aorta, duration of mechanical ventilation, intensive care unit stay and postoperative complications. Fourteen (14) neonates were discharged from our Clinic. Results: Out of a total of 85 children, 15/85 (17.6 %) were neonates; males 12/15(80%) females 3/15 (20 %). The overall mortality was 1/15% (6.6%). There were 13/15 (86.6%) corrective procedures and 2/15 (13.3%) palliative ones. The mean duration of CPB was 46.6 min. (18±296 min.), the mean duration of x-cross of aorta was 17.5 min. (10±65 min.). The mean duration of mechanical ventilation was 3.4 days (1±15 days), duration of inotropic support was 4.2 days (1± 16 days) and ICU stay was 5.8 days (7.9 ± 14days). After the operation, 2/15 (13.3%) neonates required reintubation in the ICU. Postoperative complications were confirmed in 3 neonates (intracranial bleeding with seizures, block nodes AV and pneumonia). The incidence of all postoperative complications was 6.6%. Fourteen (14) patients were discharged from the Clinic. Conclusion: Due to adequate cardiac surgery, significant technological advances, devices and increasing experience in neonatal cardiac surgery we have improved postoperative outcomes.