Tracheoesophageal fistula and associated congenital heart disease: implications for anesthetic management and survival.
Paediatr Anaesth
; 15(10): 862-9, 2005 Oct.
Article
em En
| MEDLINE
| ID: mdl-16176315
ABSTRACT
BACKGROUND:
Infants with tracheoesophageal fistula (TEF) and/or esophageal atresia (EA) frequently have other associated congenital anomalies which can have a significant impact on their anesthetic care and survival to discharge.METHODS:
A medical record review and retrospective data analysis were performed in a university affiliated children's hospital of all infants undergoing TEF/EA repair between January 1998 and July 2004. The incidence of intraoperative complications during the TEF repair and overall survival to hospital discharge was compared in two groups of infants 26 patients with TEF/EA and coexisting congenital heart disease (CHD), and 27 patients with TEF/EA and no CHD.RESULTS:
The overall incidence of intraoperative critical events during repair of TEF/EA was significantly higher in infants with associated cardiac pathology (P = 0.003). Six of 53 infants died during hospitalization (overall mortality, 11.3%) and all had associated cardiac pathology. In comparison with nonductal-dependent lesions, the presence of a ductal-dependent cardiac lesion appeared to significantly increase patient mortality (57% vs. 10%, P = 0.028).CONCLUSIONS:
Low birth weight (<1500 g) and associated cardiac pathology were found to be independent predictors of mortality in infants undergoing surgery for TEF/EA repair. The presence of a ductal-dependent cardiac lesion further increased the risk of morbidity and mortality, in addition to necessitating special anesthesia considerations.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Fístula Traqueoesofágica
/
Mortalidade Hospitalar
/
Atresia Esofágica
/
Cardiopatias Congênitas
/
Anestesia Geral
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
/
Male
/
Newborn
Idioma:
En
Revista:
Paediatr Anaesth
Assunto da revista:
ANESTESIOLOGIA
/
PEDIATRIA
Ano de publicação:
2005
Tipo de documento:
Article
País de afiliação:
Estados Unidos