Ozalp Serife, Gumus Ozcan Funda
Department of Anesthesiology and Reanimation, Istanbul Health Sciences University Basaksehir Cam and Sakura Hospital, Istanbul 34480, Turkey.
Diagnostics (Basel). 2025 Jul 22;15(15):1839. doi: 10.3390/diagnostics15151839.
Down syndrome (DS) is associated with unique anatomical and physiological characteristics that complicate the perioperative management of infants undergoing cardiac surgery. While ventricular septal defect (VSD) repair is commonly performed in this population, detailed data comparing perioperative outcomes in DS versus non-syndromic infants remain limited. This retrospective matched study analysed 100 infants (50 with DS and 50 without DS) who underwent isolated VSD closure between January 2021 and January 2025. Patients were matched by age and surgical date. Intraoperative anesthetic management, complications, postoperative outcomes, and mortality were compared between groups. DS patients had lower age, weight, and height at surgery. They required significantly smaller endotracheal tube sizes, more intubation and vascular access attempts. The DS group had significantly lower rates of extubation in the operating room and experienced longer durations of mechanical ventilation and ICU stay. However, no significant differences were observed in total hospital stay or mortality between groups. Although DS infants present with increased anesthetic complexity and respiratory challenges, they do not exhibit higher surgical mortality following isolated VSD closure. Tailored perioperative strategies may improve respiratory outcomes in this high-risk group.
唐氏综合征（DS）与独特的解剖和生理特征相关，这使得接受心脏手术的婴儿围手术期管理变得复杂。虽然室间隔缺损（VSD）修复术在这一人群中较为常见，但比较DS患儿与非综合征患儿围手术期结局的详细数据仍然有限。这项回顾性匹配研究分析了2021年1月至2025年1月期间接受单纯VSD闭合术的100例婴儿（50例患有DS，50例未患DS）。患者按年龄和手术日期进行匹配。比较了两组之间的术中麻醉管理、并发症、术后结局和死亡率。DS患者手术时的年龄、体重和身高较低。他们所需的气管导管尺寸明显更小，插管和血管通路建立尝试次数更多。DS组在手术室拔管率显著较低，机械通气时间和入住重症监护病房（ICU）时间更长。然而，两组之间在总住院时间或死亡率方面未观察到显著差异。尽管DS婴儿的麻醉复杂性和呼吸挑战增加，但在单纯VSD闭合术后，他们并未表现出更高的手术死亡率。量身定制的围手术期策略可能会改善这一高危群体的呼吸结局。
