ArticleThe Annals of thoracic surgery2018
Duration of Postoperative Mechanical Ventilation as a Quality Metric for Pediatric Cardiac Surgical Programs.
Article in The Annals of thoracic surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Cardioplegia in paediatric cardiac surgery: a systematic review of randomized controlled trials.Interactive cardiovascular and thoracic surgery · 2019Pooled it
- Hemofilters versus hemodialyzers: impacts on cytokine removal during cardiopulmonary bypass in pediatric cardiac surgery: a randomized controlled trial.Journal of cardiothoracic surgery · 2026Trial
- Late Gestation Fetal Growth in Infants Undergoing Stage 1 Palliation for Single Ventricle Heart Disease.Pediatric cardiology · 2026Article
- The Practice of Extubation Readiness Testing in Pediatric Cardiac Intensive Care Units: A Cross-sectional Study Based on an Electronic Survey.CJC pediatric and congenital heart disease · 2026Article
- Neurodevelopment at 24 Months of Age of Children Born Preterm with Congenital Heart Disease.Pediatric cardiology · 2026Article
- Immune Unresponsiveness to Cardiopulmonary Bypass Is Associated With Unfavorable Outcome in Infants Requiring Cardiac Surgery.JACC. Basic to translational science · 2026Article
- Predicting Reintubation in Postoperative Pediatric Cardiac Surgery: A Machine Learning Approach.Annals of cardiac anaesthesia · 2026Article
- Prolonged Mechanical Ventilation and Extubation Failure in Children and Adolescents Undergoing Cardiac Surgery.Brazilian journal of cardiovascular surgery · 2025Article
- Perioperative Factors and Radiographic Severity Scores for Predicting the Duration of Mechanical Ventilation After Arterial Switch Surgery.Journal of cardiothoracic and vascular anesthesia · 2024Article
- Congenital heart diseases with airway stenosis: a predictive nomogram to risk-stratify patients without airway intervention.BMC pediatrics · 2023Article
- Regression Trees and Ensemble for Multivariate Outcomes.Sankhya. Series B. [Methodological.] · 2023Article
- A simple-to-use nomogram for predicting prolonged mechanical ventilation for children after Ebstein anomaly corrective surgery: a retrospective cohort study.BMC anesthesiology · 2023Article
- Vasoactive-ventilation-renal score and outcomes in infants and children after cardiac surgery.Frontiers in pediatrics · 2023Article
- The Spillover Effects of Quality Improvement Beyond Target Populations in Mechanical Ventilation.Critical care explorations · 2022Article
- Improvement in Pediatric Cardiac Surgical Outcomes Through Interhospital Collaboration.Journal of the American College of Cardiology · 2019Article
- What are the important morbidities associated with paediatric cardiac surgery? A mixed methods study.BMJ open · 2019Article
- Extubation Failure Rates After Pediatric Cardiac Surgery Vary Across Hospitals.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2019Article
- Effects of on-table extubation on resource utilization and maternal anxiety in children undergoing congenital heart surgery in a low-resource environment.Annals of pediatric cardiologyArticle
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Authors and funding
13 authors.
Funding
Abstract
backgroundFew metrics exist to assess quality of care at pediatric cardiac surgical programs, limiting opportunities for benchmarking and quality improvement. Postoperative duration of mechanical ventilation (POMV) may be an important quality metric because of its association with complications and resource utilization. In this study we modelled case-mix-adjusted POMV duration and explored hospital performance across POMV metrics.
methodsThis study used the Pediatric Cardiac Critical Care Consortium clinical registry to analyze 4,739 hospitalizations from 15 hospitals (October 2013 to August 2015). All patients admitted to pediatric cardiac intensive care units after an index cardiac operation were included. We fitted a model to predict duration of POMV accounting for patient characteristics. Robust estimates of SEs were obtained using bootstrap resampling. We created performance metrics based on observed-to-expected (O/E) POMV to compare hospitals.
resultsOverall, 3,108 patients (65.6%) received POMV; the remainder were extubated intraoperatively. Our model was well calibrated across groups; neonatal age had the largest effect on predicted POMV. These comparisons suggested clinically and statistically important variation in POMV duration across centers with a threefold difference observed in O/E ratios (0.6 to 1.7). We identified 1 hospital with better-than-expected and 3 hospitals with worse-than-expected performance (p < 0.05) based on the O/E ratio.
conclusionsWe developed a novel case-mix-adjusted model to predict POMV duration after congenital heart operations. We report variation across hospitals on metrics of O/E duration of POMV that may be suitable for benchmarking quality of care. Identifying high-performing centers and practices that safely limit the duration of POMV could stimulate quality improvement efforts.
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