The purpose of this study was to identify factors that influence postoperative intensive care unit length of stay (ICULOS) in infants less than 6 months of age undergoing congenital heart surgery.
Records from a single institution, from January 2000 to December 2000, were reviewed. For analysis, surgical severity was characterized using an ordinal scoring system, the Aristotle Basic Complexity Score (ABCS; range 1-4).
Of 221 infants, 63 had elective surgery, that is, admission to the cardiac intensive care unit after surgery, and 158 had nonelective surgery with admission to the cardiac intensive care unit preoperatively. Elective vs. Nonelective groups differed: ABCS (median 2 vs. 3, P < .001), age at surgery (mean 110 + 10.5 vs. 27 + 3.7 days, P < .001), ICULOS (median 3.5 vs. 7 days, P < .000), and mortality (0% vs. 12.7%P < .0001). Step-wise multiple regression was performed using the natural log of ICULOS as the dependent variable. Factors associated with longer ICULOS for all 221 patients included: increasing ABCS, preoperative organ-system failure, total support time (= cardiopulmonary bypass time + deep hypothermic circulatory arrest time), total hours of postoperative ventilatory support, the need for postoperative cardiac catheterization, postoperative necrotizing enterocolitis, and postoperative nasogastric feeds. Higher preoperative weight and surgical repair vs. palliation were associated with a decrease in ICULOS.
In conclusion, preoperative organ dysfunction, need for nasogastric feeding, and total support time may offer measurable variables useful in predicting that infant at greatest risk for extended ICULOS.
"These guidelines include a feeding and nutrition checklist that can be used to assess an infant's weight changes, GI issues, physiological status, vocal cord integrity, and behavior during feeding (i.e., maturity of sucking, coughing, or choking). The increased risk of ongoing malnutrition and poor feeding compromises the outcome of cardiac surgery, lengthens hospital stay, and increases morbidity (Gillespie et al., 2006; Golbus et al., 2011; Jadcherla et al., 2009). A recent systematic review of feeding complications in infants with univentricle anatomy suggests that non-nutritive sucking and attention to early oral feeding behaviors could improve postoperative outcomes (Golbus et al., 2011). "
[Show abstract][Hide abstract] ABSTRACT: The purpose of this pilot study was to determine the effects of oral motor stimulation on infants born with complex univentricle anatomy who required surgery shortly after birth. A quasi-experimental group design was used to compare 18 infants receiving an oral motor stimulation program with 10 infants who did not receive any oral motor intervention. Infants in the treatment group received the oral motor treatment prior to cardiac surgery and immediately following surgery, one time a day, 6 days a week. Outcomes data were collected for length of time to reach full bottle-feeds and length of hospital stay. A statistically significant difference was seen in the overall length of hospital stay between the two groups (p = .04). Infants in the experimental group were hospitalized for a mean of 28.6 days and infants in the comparison group for a mean of 35.3 days. Infants in the treatment group achieved full bottle-feeds 2 days earlier than infants in the comparison group, although this was not statistically significant. There is positive support for the use of oral motor stimulation for infants born with univentricle anatomy, but further study is needed to determine the long-lasting effects of this intervention.
[Show abstract][Hide abstract] ABSTRACT: The present paper deals with the methods of modeling radar echo
data of an object on a rotating platform with physical optics (PO)
method in the case of large rotating angle. The echo data are directly
calculated in Cartesian coordinate system of spatial frequency and
processed with two-dimensional fast Fourier transform (2D-FFT) to obtain
the image of the object. The quality of the resulting image is much
better than images obtained using the data calculated in polar
coordinate system and interpolated to the Cartesian coordinate
distribution before performing 2D-FFT
Aerospace and Electronics Conference, 1996. NAECON 1996., Proceedings of the IEEE 1996 National; 06/1996
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