The Predictive Value of Infant-Specific Preoperative Pulmonary Function Tests in Postoperative Pulmonary Complications in Infants with Congenital Heart Diseases

Background and Objective . To investigate the relationship between infant-specific preoperative pulmonary function tests (PFTs) and postoperative pulmonary complications (PPCs) in infants with congenital heart diseases (CHDs). Methods . Patients of 1-3 years of age who received surgical treatment for CHDs from January 1 st , 2009, to December 31 st , 2017, were retrieved. Records of preoperative PFTs, methods of operation, anesthesia procedures, intraoperative vital signs, respiratory support modalities, and PPCs was retrieved and analyzed. Results . 122 infants met the preset inclusion criteria, including 72 males and 50 females. There were 76 cases of thoracotomy and 46 cases of cardiac catheterization. The overall incidence of PPCs was 15.6%, including 19.7% after thoracotomy and 8.7% after cardiac catheterization, respectively (p>0.05). The incidence of PPCs was 35.4% or 2.7% in infants with a rapid or a normal respiratory rate, respectively; 42.1% or 3.6% in infants with an abnormal or a normal time to reach peak tidal expiratory flow versus the total expiratory time (TPTEF/TE), respectively; 39.0% or 3.7% in infants with an abnormal or a normal volume to peak expiratory flow versus the total expiratory volume (VPEF/VE), respectively; and 46.9% or 4.4% in infants with a decreased or a normal lung compliance, respectively (p<0.01 in all comparisons). Conclusions . The preoperative abnormal changes in respiratory rate, TPTEF/TE, VPEF/VE, and lung compliance are indicative of the risk of PPCs.