AIM To discuss the timing of surgical treatment of neonatal critical congenital heart disease and the preoperative adjustment strategy.
MATHODS From September 2019 to September 2020, 60 cases of neonatal surgery children were admitted to our hospital. Among them, 53 cases received surgical treatment and among the remaining 7 cases, 5 cases were discharged automatically and 2 cases died. The median age of the neonates undergoing surgery was 14 days. There were 37 male newborns and 16 female newborns and they were divided into two groups by within or over 14 days. The postoperative clinical indicators and the clinical prognosis of the two groups were compared.
RESULTS From September 2019 to September 2020, a total of 53 neonates underwent surgical treatment, of whom 27 neonates were within 14 days of age and 26 neonates were over 14 years old, with no significant difference in preoperative weight between the two groups (3.344 kg ± 0.428 kg vs. 3.631 kg ± 0.622 kg). There was no significant difference in the number of adjusted cases transferred to ICU before operation (16 vs. 11) and in the number of critically ill cases before operation between the two groups (9 vs. 5). The time of using ventilator after operation in the group over 14 days was significantly less than that in the group within 14 days (318 h ± 330 h vs. 156 h±167 h). The length of stay in the ICU in the over 14 days group was significantly less than that in the within 14 days group (20 d ± 17 d vs. 11 d ± 6 d). There were no significant differences in postoperative mortality, leakage, secondary intubation and delayed chest closure between the two groups.
CONCLUSION The probability of preoperative critical condition in neonatal critical congenital heart disease is not related to age. Early surgical treatment of neonatal critical congenital heart disease cannot improve the clinical prognosis. The ICU system adjustment strategy to delay the emergence of critical condition is particularly important.
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