Di̇lek Yavuzcan Öztürk1, Behzat Tüzün2

1Başakşehir Çam ve Sakura Şehir Hastanesi, Neonatoloji Kliniği, İstanbul, Türkiye
2Başakşehir Çam ve Sakura Şehir Hastanesi, Çocuk Kalp Cerrahisi Kliniği, İstanbul, Türkiye

Keywords: Newborns; congenital heart defects; intensive care

Abstract

Objectives: Total abnormal pulmonary venous return anomaly (TAPVD) is a congenital heart disease characterized by abnormal pulmonary venous drainage to the right atrium. The Neutrophil/lymphocyte ratio (NLR) is used to predict mortality and morbidity after congenital heart surgery. In this study, the effect of postoperative NLR changes on prolonged intensive care unit stay in newborns with TAPVD was searched.

Patients and Methods: The newborns with TAPVD who were followed up and operated on in the pediatric cardiac intensive care unit between May 1, 2020 and May 1, 2022 were included in the study. Hematological parameters and NLR changes were recorded before and after the operation (1st, 2nd, 3rd days). Long ICU duration (PCILOS, being in the longest 25 percent as the duration) was accepted as morbidity. The effects of NLO changes on PCILOS were examined.

Results: Twenty-four patients were included during the study period. Median age was 18 days (IQR 12 days-24 days) and median weight was 3 kg (IQR 2.8-3.2). Fifteen of the cases were male (63%). Median mechanical ventilator duration, intensive care unit stay, and hospital stay were 40 hours (IQR 30-48 hours), 7 days (IQR 5-9), and 15 days (IQR 12-18), respectively. PCILOS duration was determined as >9 days. Three patients (12.5%) died in the postoperative first 30 days. Preoperative NLR value> 1.9 and postoperative 3rd day NLR> 2.8 predicted PCILOS strongly.

Conclusion: High NLR values in the preoperative and early postoperative periods of neonates with total abnormal pulmonary venous return anomaly may be helpful to predict prolonged ICU stay.