The Science Journal of the American Association for Respiratory Care

2005 OPEN FORUM Abstracts

THE USE OF VAPOTHERM FOR PREVENTING REINTUBATION IN NEONATES WITH SINGLE VENTRICLE CONGENITAL HEART DISEASE FOLLOWING CARDIAC SURGERY.



Dana Baxter, RCP, RRT, Lori Auw, RCP, MHA. Childrens Hospital Los Angeles, Los Angeles, CA.

Background: Despite improved outcomes of children with congenital heart disease following cardiac surgery, extubation failure is a common source of morbidity in this population. At our institution, the reintubation rate by 48 hours in all children following cardiac surgery was found to be 6.8%. However, the reintubation rate in neonates with single ventricle congenital heart disease (SV) was 13.0% (9 of 69). A quality improvement (QI) project was conceived to decrease the reintubation rate in this subpopulation of children.

Hypothesis:
We hypothesized Vapotherm (high flow humidified nasal cannula) in these patients would decrease the need for reintubation.

Method:
From January 1 until May 31, 2005 all neonates with SV following cardiac surgery were evaluated at the time of extubation for use of Vapotherm. For the purpose of our QI project, extubation failure was defined as reintubation within 48 hours. Chi-square analysis was performed and a p-value < 0.05 was considered significant.

Results:
Of 43 neonates, 4 required reintubation within 48 hours (9.3%). This was not significantly different than the reintubation rate prior to the use of Vapotherm (13%, p=0.29).

Conclusion:
The application of Vapotherm to neonates with SV following cardiac surgery did not decrease the rate of reintubation. Nevertheless, we believe further studies examining its influence on duration of mechanical ventilation and incidence on ventilator-associated pneumonia is warranted.

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