Early extubation and reduced icu stay as markers of effective infusion support in children after congenital heart defect repair
Abstract
Aim. To assess the impact of different initial infusion strategies, including the use of balanced Ringer’s solution, on the early postoperative course in children after surgical correction of congenital heart defects.
Materials and methods. This prospective cohort study included 70 pediatric patients who underwent radical correction of tetralogy of Fallot. The patients were divided into two groups: the control group (0.9% NaCl) and the study group (balanced Ringer’s solution). Acid-base status, electrolyte levels, hemodynamic parameters, echocardiographic findings, as well as the time to extubation and duration of stay in the intensive care unit (ICU) were analyzed.
Results. The study group demonstrated significantly higher pH values, less pronounced hyperchloremic acidosis, stable plasma osmolality, improved cardiac output (higher ejection fraction and lower end-diastolic volume). Mean arterial pressure after 24 hours was higher, and central venous pressure remained more stable. Time to extubation and ICU stay were reduced by 31.3% and 26.6%, respectively, in the study group.
Conclusion. Optimization of infusion therapy using balanced crystalloid solutions improves myocardial function and accelerates recovery in pediatric patients after cardiac surgery, as evidenced by earlier extubation and shorter ICU stay.
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