Open AccessEffect of Prostaglandin Duration on Outcomes in Transposition of the Great Arteries with Intact Ventricular Septum
Author(s) -
Butts Ryan J.,
Ellis Alexander R.,
Bradley Scott M.,
Hulsey Thomas C.,
Atz Andrew M.
Publication year - 2012
Publication title -
congenital heart disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.828
H-Index - 42
eISSN - 1747-0803
pISSN - 1747-079X
DOI - 10.1111/j.1747-0803.2012.00631.x
Subject(s) - medicine , great arteries , inotrope , mechanical ventilation , perioperative , intensive care unit , cardiopulmonary bypass , anesthesia , population , aortic cross clamp , prostaglandin e1 , surgery , cardiology , heart disease , environmental health
Objective. To study the effects of duration of preoperative prostaglandin E1 (PGE) exposure on perioperative outcomes of the arterial switch operation in patients with transposition of the great arteries with an intact ventricular septum. Design. Retrospective chart review. Setting. Pediatric cardiac intensive care unit in a tertiary care children's hospital. Patients. All patients with transposition of the great arteries with an intact ventricular septum from 1995 to 2008. Outcome Measures. Inotropic score was calculated for all patients in the first 5 postoperative days and maximum inotropic score was recorded. Length of postoperative mechanical ventilation, fluid balance, mechanical ventilation time, as well as intensive care unit and hospital stay were recorded for all patients. Results. Study population included 59 patients, 41 (69%) underwent balloon atrial septostomy. PGE was used in 52 patients, median exposure of 59 hours, range 0 to 272 hours. Longer preoperative PGE exposure was associated with longer preoperative mechanical ventilation ( P < .001). There was no association between preoperative PGE duration and cardiopulmonary bypass time, cross‐clamp time, or total hospital stay. Patients with longer preoperative PGE exposure had a lower postoperative inotrope score (10 vs. 15 P = .02). Conclusion. Greater preoperative PGE exposure was associated with prolonged preoperative mechanical ventilation. Longer PGE exposure was associated with lower postoperative inotrope requirements. Aggressive efforts to avoid or shorten PGE infusion duration may not be warranted in this population.