To investigate the risk factors associated with prolonged ventilation after Fontan surgery.

Retrospective case series.

Tertiary childrens hospital.

We included 123 children who underwent Fontan surgery without delayed sternal closure or extracorporeal membrane oxygenation between 2011 and 2017.

Fontan surgery.

Prolonged ventilation was defined as intubation for more than 24 hours after surgery. Preoperative, intraoperative, and perioperative data were collected retrospectively from medical records. Multivariate logistic regression analysis was used to identify risk factors for prolonged ventilation. The median age and weight of patients were 2.2 years and 10.0 kg, respectively. Seventeen per cent of the patients (n = 21) received prolonged mechanical ventilation, and the median intubation period was 2.9 days. There were no 90-day or in-hospital deaths. The independent predictors of prolonged ventilation identified were fenestration (p < 0.01), low pulmonary artery index (p = 0.02), and advanced atrioventricular regurgitation (p < 0.01). The duration of ICU stay was significantly longer in the prolonged ventilation group than in the early extubation group (10 days versus 6 days, p < 0.01).

Fenestration, low pulmonary artery index, and significant atrioventricular regurgitation are risk factors for prolonged ventilation after Fontan surgery. Careful preoperative and perioperative management that considers the risk factors for prolonged ventilation in each individual is important.

调查与 Fontan 手术后延长通气相关的危险因素。

回顾性案例系列。

三级儿童医院。

我们纳入了 123 名在 2011 年至 2017 年间接受 Fontan 手术且未延迟胸骨闭合或体外膜肺氧合的儿童。

丰坦手术。

延长通气定义为术后插管超过 24 小时。从病历中回顾性收集术前、术中和围手术期数据。多变量逻辑回归分析用于确定长期通气的危险因素。患者的中位年龄和体重分别为 2.2 岁和 10.0 kg。17% 的患者（n = 21）接受了长时间的机械通气，中位插管时间为 2.9 天。没有 90 天或院内死亡。确定的延长通气时间的独立预测因素是开窗（p < 0.01）、低肺动脉指数（p = 0.02）和晚期房室反流（p < 0.01）。

开窗、低肺动脉指数和明显的房室反流是 Fontan 手术后延长通气时间的危险因素。考虑到每个人延长通气的风险因素，仔细的术前和围手术期管理很重要。