Indian journal of anaesthesia · 2026
Thoracic fluid content as a predictor of ventilatory weaning and postoperative pulmonary complications in infants undergoing open heart surgery: A prospective observational study.
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Das Devishree, Choudhury Minati, Makhija Neeti, Chauhan Sandeep, Velayoudam Devagourou, Rajashekar Palleti
Аннотация
BACKGROUND AND AIMS: Infants undergoing open heart surgery (OHS) are at potential risk of postoperative pulmonary complications due to fluid overload following cardiopulmonary bypass (CPB), which may delay weaning from mechanical ventilation. Therefore, this study aimed to evaluate the postoperative thoracic fluid content (TFC) by electrical cardiometry in predicting successful weaning from mechanical ventilation in infants undergoing OHS.
METHODS: A prospective observational study was conducted in a tertiary referral cardiac centre over a 1-year period, from July 2022 to June 2023, and 100 infants undergoing elective OHS were analysed. Postoperatively, TFC was evaluated for prediction of extubation and pulmonary complications. Also, conventional lung ultrasound (LUS) and chest radiographs were correlated. The association with CPB duration, aortic clamp time, and postoperative clinical variables were assessed for ventilatory duration, intensive care unit, and hospital length of stay in this cohort of infants.
RESULTS: In this study, 64 patients underwent successful weaning from mechanical ventilation (Group SW) within 12 hours following surgery (n = 64), while 36 infants required prolonged mechanical ventilation, hence delayed weaning (Group DW) (n = 36). The TFC was significantly higher in Group DW than in Group SW. TFC > 45 kΩ-1 can be considered as a predictor of delayed weaning (Area under curve = 0.94, P value < 0.001) with 91% sensitivity and 97% specificity. LUS score >14.5 and chest radiograph score >2.5 can predict delayed weaning. TFC > 37 kΩ-1 was associated with postoperative pulmonary complications in our study.
CONCLUSION: TFC > 45 kΩ-1 was associated with delayed weaning in infants following OHS. Additionally, electrical cardiometry can be used as an objective bedside trend monitor for assessing postoperative pulmonary complications in this cohort.
METHODS: A prospective observational study was conducted in a tertiary referral cardiac centre over a 1-year period, from July 2022 to June 2023, and 100 infants undergoing elective OHS were analysed. Postoperatively, TFC was evaluated for prediction of extubation and pulmonary complications. Also, conventional lung ultrasound (LUS) and chest radiographs were correlated. The association with CPB duration, aortic clamp time, and postoperative clinical variables were assessed for ventilatory duration, intensive care unit, and hospital length of stay in this cohort of infants.
RESULTS: In this study, 64 patients underwent successful weaning from mechanical ventilation (Group SW) within 12 hours following surgery (n = 64), while 36 infants required prolonged mechanical ventilation, hence delayed weaning (Group DW) (n = 36). The TFC was significantly higher in Group DW than in Group SW. TFC > 45 kΩ-1 can be considered as a predictor of delayed weaning (Area under curve = 0.94, P value < 0.001) with 91% sensitivity and 97% specificity. LUS score >14.5 and chest radiograph score >2.5 can predict delayed weaning. TFC > 37 kΩ-1 was associated with postoperative pulmonary complications in our study.
CONCLUSION: TFC > 45 kΩ-1 was associated with delayed weaning in infants following OHS. Additionally, electrical cardiometry can be used as an objective bedside trend monitor for assessing postoperative pulmonary complications in this cohort.