Postoperative treatment contributions to post-traumatic stress symptoms in preschool-aged children after cardiac surgery

Advancements in pediatric cardiac surgery have led to improved survival for congenital heart disease. Children who survive cardiac surgery are high risk for non-cardiac comorbidities, including post-traumatic stress symptoms (PTSS). However, few studies have examined PTSS in preschool children following cardiac surgery. The purpose of this study was to examine relationships between postoperative variables (cardiac physiology, postoperative intensive care unit length of stay, duration of mechanical ventilation, number of prior surgeries) and the development of PTSS in children between three and six years old following cardiac surgery. Primary caregivers of children aged three to six years who underwent cardiac surgery between 2018 and 2020 were invited to participate in this cross-sectional, descriptive study. We obtained data related to the child's surgery through medical chart review. Caregivers completed the Young Child Posttraumatic Stress Disorder Checklist to explore child PTSS. We assessed the strength and direction of the relationships between postoperative variables and child PTSS using correlational methods. Caregivers of children with single ventricle physiology reported greater child PTSS than those with biventricular physiology. Length of stay, duration of mechanical ventilation, and number of prior surgeries were not significantly associated with child PTSS. Results demonstrated that preschool-aged children may develop PTSS following cardiac surgery. Those with single ventricle physiology may be more susceptible to the development of PTSS than children with biventricular physiology. Additional work is needed to identify risk factors for the development of PTSS in preschool children following cardiac surgery. • Preschoolers who undergo cardiac surgery may display posttraumatic stress symptoms. • Children with single ventricle physiology may be at higher risk for PTSS. • Children with single physiology have longer time on the ventilator and in the ICU. • Further research is needed to determine whether delirium and PTSS are related.