Early prone positioning after tetralogy of fallot repair in children: a retrospective cohort study of oxygenation, safety, and short-term outcomes.

Xiaoqin Huang, Shaoping Su, Yang Du, Qi Liu, Zhanhao Su, Lixia Lin

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Article in Frontiers in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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Xiaoqin Huang *Department of the Intensive Care Unit of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.

Shaoping Su *Huizhou Central People's Hospital, Huizhou, China.

Yang DuDepartment of Organ Transplantation, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.

Qi LiuDepartment of the Intensive Care Unit of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.

Zhanhao SuDepartment of the Intensive Care Unit of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.

Lixia LinDepartment of the Intensive Care Unit of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.

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6 · The paper itself

Abstract

Aim: To assess whether early prone positioning is associated with differences in gas-exchange indices at prespecified postoperative time points after complete tetralogy of Fallot (TOF) repair in children, without evidence of hemodynamic instability. We also explored associations between early respiratory indices and short-term outcomes. Methods: This was a single-center retrospective cohort study of patients aged <18 years undergoing complete TOF repair. Groups were defined by positioning during the first 12 postoperative hours: prone ( Results: Prone positioning was associated with higher oxygenation indices vs. supine (higher PaO₂ at 1, 4, 8, 12 h; higher PaO₂/FiO₂ at 4, 8, 12 h) and with lower PaCO₂ at 8 and 12 h (all Conclusions: Early short-duration prone positioning was associated with differences in gas-exchange indices at prespecified time points without evidence of hemodynamic instability after pediatric TOF repair, while short-term outcomes were similar. Findings support feasibility and warrant prospective multicenter evaluation to define optimal timing and duration.

Indexed as

oxygenation index (PaO₂/FiO₂ ratio)pediatric cardiac surgeryprone positioningtetralogy of fallotventilator-associated pneumonia

Identifiers

PMID42039344

DOI10.3389/fcvm.2026.1696761

PMCPMC13106187

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