All issues > Volume 41(5); 1998

Original Article

J Korean Pediatr Soc. 1998;41(5):633-639. Published online May 15, 1998.

Relation of Postoperative Complication and Duration of Artificial Ventilation in Infants with Large Ventricular Septal Defect

Jeong-Yeol JY Song¹, Hyang-Suk HS Yoon¹, Hyun-Woong HW Yang², Jong-Bum JB Choi², Soon-Ho SH Choi²

¹Department of Pediatrics, School of Medicine, Wonkwang University, Iksan, Korea
²Department of Thoracic Surgery and Cardiovascular, School of Medicine, Wonkwang University, Iksan, Korea

Abstract

Purpose
: The importance of postoperative management of those who have undergone intracardiac repair for congenital heart diseases has increased in recent years. In this study, we investigated postoperative complications and their relations to preoperative age or duration of the intubation and artificial ventilation in infants with large symptomatic ventricular septal defect.
Methods
: Between January, 1993 and December, 1996, sixty infants underwent primary closure of a ventricular septal defect(VSD). The patients were divided into two groups based on preoperative age : group 1, infants aged 6 month or less(n=40), and group 2, infants aged more than 6 month (n=20). And, another three groups were divided into 3 groups due to the duration of the intubation and artificial ventilation including <24 hour and 24-48 hour, >48 hour, respectively. We compared the incidence of complications such as infection, respiratory or cardiovascular complications among each group.
Results
: No specific differences between two age groups were found, but the incidence of right bundle branch block was high in age group of 6 month or less(P<0.05). The incidence of sepsis was high in group of >48 hour(P<0.05). And also, arrhythmias, atelectasis, toxic hepatitis were more frequently observed in the former group.
Conclusion
: These results indicate that early weaning of the artificial ventilation in infants with large symptomatic ventricular septal defect could protect them from development of severe life- threatening infection such as sepsis. We suggest 48 hours or less as the optimal duration of artificial ventilation. Additionally, earlier weaning could provide earlier oral feeding or earlier ambulation, which is improve respiratory homeostasis.

Keywords :Ventricular septal defect, Artificial ventilation, Postoperative complication