Mechanical ventilation management in patients diagnosed with Covid-19 who underwent pediatric openheart surgery

Abstract

The new pneumonia pathogen "Covid-19" has been causing the pandemic since December 2019. There has been an increase in the number of cases reported in the pediatric population, particularly in adult patients. In the pediatric population, where asymptomatic transmission is standard, some mandatory protocol changes in preoperative and postoperative mechanical ventilation management must be made concerning pediatric cardiac surgery. Our study retrospectively reviewed 215 patients operated on in our pediatric cardiac surgery clinic from March 11, 2020, to April 15, 2021. Eleven patients who were asymptomatic preoperatively and had rt-PCR (-) but had rt-PCR (+) in the postoperative period and 15 patients who required emergency surgery and had rt-PCR (+) in the preoperative period were included in the study. The intensive care period of the patients ranged from 2 to 51 days, with an average of 10.61 ± 13.58 days. The duration of stay connected to the ventilator is 1 to 44 days. It was found that the total time spent on a ventilator was 8.11±13.27 days. The average service follow-up time was 9.23±5.54 days, with a range of 0 to 21 days. Three of the patients required ECMO, and all of those who required ECMO died. Mechanical ventilation management in pediatric patients should be adjusted according to the patient's unique underlying pathophysiology and conducted under the physician's close clinical supervision. While a lung-protective approach is critical in this patient group, where barotrauma occurs frequently, each clinic should handle the process according to its resources and experience.

Keywords

• Barotruma
• COVID-19
• Mechanical ventilation
• Pediatric cardiac surgery