high-frequency oscillatory ventilation and short-term outcome in neonates and infants undergoing cardiac surgery a propensity score analysis高频振荡通气和短期结果接受心脏手术的新生儿和婴儿倾向得分分析.pdfVIP

Bojan et al. Critical Care 2011, 15:R259 /content/15/5/R259 RESEARCH Open Access High-frequency oscillatory ventilation and short- term outcome in neonates and infants undergoing cardiac surgery: a propensity score analysis 1* 1 2 1 Mirela Bojan , Simone Gioanni , Philippe Mauriat and Philippe Pouard Abstract Introduction: Experience with high-frequency oscillatory ventilation (HFOV) after congenital cardiac surgery is limited despite evidence about reduction in pulmonary vascular resistance after the Fontan procedure. HFOV is recommended in adults and children with acute respiratory distress syndrome. The aim of the present study was to assess associations between commencement of HFOV on the day of surgery and length of mechanical ventilation, length of Intensive Care Unit (ICU) stay and mortality in neonates and infants with respiratory distress following cardiac surgery. Methods: A logistic regression model was used to develop a propensity score, which accounted for the probability of being switched from conventional mechanical ventilation (CMV) to HFOV on the day of surgery. It included baseline characteristics, type of procedure and postoperative variables, and was used to match each patient with HFOV with a control patient, in whom CMV was used exclusively. Length of mechanical ventilation, ICU stay and mortality rates were compared in the matched set. Results: Overall, 3,549 neonates and infants underwent cardiac surgery from January 2001 through June 2010, 120 patients were switched to HFOV and matched with 120 controls. After adjustment for the delay to sternal closure, duration of renal replacement therapy, occurrence of pulmonary hypertension and year of surgery, the probability of successful weani