How common is severe XXXX after pediatric cardiac surgery?

@entity1 @entity120 @entity474 @entity842 @entity551
BACKGROUND: @entity120 may result in significant morbidity and mortality after pediatric cardiac surgery. The objective of this study was to determine the incidence and outcome of severe @entity120 , defined as a ratio of @entity551 equal to or greater than 1.0, after cardiac surgery in @entity1 . METHODS: Data from all @entity1 younger than 18 years who had undergone cardiothoracic surgery from January 1, 1994, to December 31, 1998, were examined. To find @entity1 with severe @entity120 , we reviewed intensive care unit charts from @entity1 who had been monitored with a pulmonary artery catheter after the operation (n = 151), had received mechanical ventilation for more than 4 days after the operation (n = 124), or had died in the operating room or the intensive care unit (n = 22). Intraoperative and postoperative measurements of mean pulmonary arterial pressure and postoperative echocardiographic studies during the first 3 postoperative days were used to select the @entity1 . RESULTS: During the study period, 1349 @entity1 (including 164 neonates and 511 @entity1 , median age 12 months) underwent cardiac operations with an overall perioperative mortality of 22 @entity1 (1.6%). Twenty-seven @entity1 (2%, median age 4.2 months) had severe @entity120 . Of these, 2 (7.4%) died within 30 days of the operation, and 3 others (11%) died within a year (median follow-up 53 months). @entity842 inhalation was used in 5 of the 27 cases, and it probably saved the life of 1 @entity1 , may have helped in 1 case, and had no discernible effect in 3 cases. @entity120 was most common after correction of complete @entity474 (14%, n = 12/85). Thirteen of 131 @entity1 with Down syndrome (9.9%) had severe @entity120 . CONCLUSION: Severe postoperative @entity120 occurred after 2% of the cardiac procedures and in most cases was managed successfully with conventional treatment and had a favorable postoperative outcome. The low incidence relative to previous reports may reflect the benefits of early correction and improved intraoperative and postoperative care.
