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Risk factors for morbidities and mortality in children following pneumonectomy
Author(s) -
Giubergia Verónica,
Alessandrini Florencia,
Barrias Carolina,
Giuseppucci Carlos,
Reusmann Aixa,
Barrenechea Marcelo,
Castaños Claudio
Publication year - 2017
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1111/resp.12867
Subject(s) - medicine , atelectasis , surgery , pneumonectomy , bronchiectasis , empyema , pneumothorax , mortality rate , respiratory distress , bronchopleural fistula , pneumonia , sepsis , pediatrics , lung
Background and objective Pneumonectomy ( PNE ) is a procedure infrequently performed in children. A high morbidity/mortality rate associated with PNE has been described. Few series have been published in the last 15 years. Risk factors associated with morbidity/mortality after PNE were evaluated. Indications, course, survival and complications of PNE in children were also analized. Methods In a case series of 51 children who underwent PNE , death within 30 days of surgery, pneumonia, empyema, sepsis, adult respiratory distress syndrome, bronchopleural fistula, bleeding, pneumothorax and post‐ PNE syndrome were considered major morbidities. Scoliosis, wound infection and atelectasis were considered minor morbidities. Results Median age at PNE was 7.4 years; 45% were males. Indications of pneumonectomy were postinfectious bronchiectasis (61%), tumours (17%), pulmonary malformations (17%), aspiration syndrome (14%), cystic fibrosis (6%), immunodeficiency (4%) and trauma (2%). Mortality rate was 4% at 1 month. Major and minor morbidities were present in 23% and 27% of patients, respectively. Risk factors for development of morbidities after PNE were age ≤ 3 years ( OR : 16.7; 95% CI : 2.4–117) and the need for mechanical ventilation for at least 4 days ( OR : 8; 95% CI : 1.5–43.6). Conclusion Children are at high risk of death, major and minor morbidities following PNE . Caution is recommended for this group of patients.