Khokhar Rajab A, Gowa Murtaza A, Bangash Sohail K, Tahir Amber
Pediatric Critical Care, National Institute of Cardiovascular Diseases, Karachi, PAK.
Pediatric Critical Care, National Institute of Child Health, Karachi, PAK.
Cureus. 2019 Aug 7;11(8):e5339. doi: 10.7759/cureus.5339.
Introduction Congenital heart disease (CHD) is the most common birth defect globally, with low-to-middle income Asian countries registering the highest incidence. Every year, 60,000 babies are born with varying severity of CHD in Pakistan. But the country has only three pediatric intensive care units (PICU) fully dedicated to child cardiac surgery patients. The focus of this study is to analyze the spectrum of pediatric cardiac surgical procedures performed for the management of CHD and their outcomes in a cardiac PICU in Pakistan. Methods In this analysis, all surgical records of children admitted to the PICU of National Institute of Cardiovascular Diseases (NICVD), Karachi, from October 2018 to March 2019 were included. It is a 14-bed, state-of-the-art cardiac PICU, which provides high-quality care to critical post-surgical patients. Results The surgical records of 537 patients were extracted for the purpose of our study, which accounted for 89.5 of post-operative patients admitted in the PICU per month and three per day. Tetralogy of Fallot (TOF) was the most commonly treated anomaly (n = 161; 29.9%) in the facility, followed by ventricular septal defect (n = 107; 19.9%). The overall mortality rate was 5.4% (n = 29), out of which 27.5% (n = 8) were TOF-related. Conclusions There is a very high burden of patients on the cardiac PICUs in low-to-middle income Asian countries. Despite the lack of resources, the high- quality care provided by pediatric cardiac critical-care specialists at these PICUs has ensured favorable outcomes and a mortality rate as low as that in any of the developed countries.
引言
先天性心脏病（CHD）是全球最常见的出生缺陷，在亚洲中低收入国家发病率最高。每年，巴基斯坦有6万名患有不同严重程度先天性心脏病的婴儿出生。但该国仅有三个儿科重症监护病房（PICU）完全致力于儿童心脏手术患者。本研究的重点是分析在巴基斯坦一家心脏PICU中为治疗先天性心脏病而进行的儿科心脏外科手术范围及其结果。
方法
在本分析中，纳入了2018年10月至2019年3月在卡拉奇国家心血管疾病研究所（NICVD）的PICU住院的所有儿童手术记录。这是一个拥有14张床位的先进心脏PICU，为术后重症患者提供高质量护理。
结果
为我们的研究目的提取了537例患者的手术记录，占PICU每月收治的术后患者的89.5%，每天3例。法洛四联症（TOF）是该机构最常治疗的异常疾病（n = 161；29.9%），其次是室间隔缺损（n = 107；19.9%）。总死亡率为5.4%（n = 29），其中27.5%（n = 8）与TOF相关。
结论
亚洲中低收入国家的心脏PICU患者负担非常重。尽管资源匮乏，但这些PICU的儿科心脏重症监护专家提供的高质量护理确保了良好的结果，死亡率与任何发达国家一样低。
