Risk Factors of Prolonged Mechanical Ventilation in Infants With Pierre Robin Sequence After Mandibular Distraction Osteogenesis: A Retrospective Cohort Study
Open Access
- 12 April 2021
- journal article
- research article
- Published by Frontiers Media SA in Frontiers in Pediatrics
Abstract
Background: After mandibular distraction osteogenesis (MDO), most infants with Pierre Robin sequence (PRS) require mechanical ventilation to assist their breathing. However, the optimal duration of intubation during early mandibular distraction osteogenesis activation is poorly understood. This retrospective study was carried out to identify perioperative risk factors of prolonged mechanical ventilation in infants undergoing MDO. Methods: A total of 95 infants with PRS underwent MDO at Guangzhou Women and Children's Medical Center between 2016 and 2018, and the clinical records of 74 infants who met the selection criteria were analyzed. Of the 74 infants, 26 (35.1%) underwent prolonged mechanical ventilation, 48 (64.9%) did not. t-test, Wilcoxon Sum Rank test or chi-squared test were performed to compare variables that might associate with prolonged mechanical ventilation between the two groups, and then, significant variables identified were included in the multivariate logistic regression model to identify independent variables. Results: Univariate logistic regression analysis revealed that age, preoperative gonial angle, and postoperative pulmonary infection were associated with prolonged mechanical ventilation (all P < 0.05). Multivariate logistic regression analysis confirmed that the preoperative gonial angle and postoperative pulmonary infection were independent risk factors of prolonged mechanical ventilation (both P < 0.05). Conclusions: Infants with PRS and smaller preoperative gonial angle or postoperative pulmonary infection may be more likely to undergo prolonged mechanical ventilation after MDO. For others, extubation may be attempted within 6 days after MDO.This publication has 27 references indexed in Scilit:
- Longer duration of mechanical ventilation was found to be associated with ventilator-associated pneumonia in children aged 1 month to 12 years in IndiaJournal of Clinical Epidemiology, 2013
- Anesthetic implications of infants with mandibular hypoplasia treated with mandibular distraction osteogenesisPediatric Anesthesia, 2012
- The successful use of the nasopharyngeal airway in Pierre Robin sequence: an 11-year experienceArchives of Disease in Childhood, 2012
- Pediatric Airway Maintenance and Clearance in the Acute Care Setting: How To Stay Out of TroubleRespiratory Care, 2011
- Robin Sequence: From Diagnosis to Development of an Effective Management PlanPEDIATRICS, 2011
- Controversies in the Diagnosis and Management of the Robin SequenceThe Journal of Craniofacial Surgery, 2011
- Changes in serum IGF-1 and IGFBP-3 levels and growth in children following adenoidectomy, tonsillectomy or adenotonsillectomyInternational Journal of Pediatric Otorhinolaryngology, 2010
- Effects of dynamic exercise on circulating IGF-1 and IGFBP-3 levels in patients with rheumatoid arthritis or ankylosing spondylitisClinical Rheumatology, 2007
- Using a Modified Nutrition Plate for Early Intervention in a Newborn Infant with Pierre Robin Sequence: A Case ReportThe Cleft Palate Craniofacial Journal, 2006
- Incidence of the Robin Anomalad (Pierre Robin syndrome)British Journal of Plastic Surgery, 1983