Singh Sarvesh Pal, Chauhan Sandeep, Choudhury Minati, Malik Vishwas, Talwar Sachin, Hote Milind P, Devagourou Velayoudham
Department of Cardiac Anesthesia, Cardio-Thoracic Sciences Center, All India Institute of Medical Sciences, New Delhi, India.
Ann Card Anaesth. 2014 Jul-Sep;17(3):191-7. doi: 10.4103/0971-9784.135847.
The aim was to compare various pre-and post-operative parameters and to identify the predictors of mortality in neonates, infants, and older children undergoing Modified Blalock Taussig shunt (MBTS).
Medical records of 134 children who underwent MBTS over a period of 2 years through thoracotomy were reviewed. Children were divided into three groups-neonates, infants, and older children. For analysis, various pre-and post-operative variables were recorded, including complications and mortality.
The increase in PaO 2 and SaO 2 levels after surgery was similar and statistically significant in all the three groups. The requirement of adrenaline, duration of ventilation and mortality was significantly higher in neonates. The overall mortality and infant mortality was 4.5% and 8%, respectively.
Neonates are at increased risk of complications and mortality compared with older children. Age (<30 days), weight (<3 kg), packed red blood cells transfusion >6 ml/kg, mechanical ventilation >24 h and post shunt increase in PaO 2 (P Diff) <25% of baseline PaO 2 are independent predictors of mortality in children undergoing MBTS.
比较不同年龄段（新生儿、婴儿及大龄儿童）行改良布-塔分流术（MBTS）患者术前及术后的各项参数，并确定其死亡的预测因素。
回顾了134例在2年期间通过开胸手术行MBTS的儿童的病历。将儿童分为三组——新生儿、婴儿及大龄儿童。分析时记录了各种术前及术后变量，包括并发症和死亡率。
三组术后动脉血氧分压（PaO₂）和动脉血氧饱和度（SaO₂）水平的升高相似且具有统计学意义。新生儿肾上腺素的使用需求、通气时间及死亡率显著更高。总体死亡率和婴儿死亡率分别为4.5%和8%。
与大龄儿童相比，新生儿发生并发症和死亡的风险更高。年龄（<30天）、体重（<3kg）、浓缩红细胞输注量>6ml/kg、机械通气>24小时以及分流术后PaO₂升高幅度（P差值）<基础PaO₂的25%是行MBTS儿童死亡的独立预测因素。
