改良超滤在婴幼儿体外循环心脏手术中的应用

目的观察改良超滤技术对婴幼儿体外循环心脏手术的影响. 方法自2003年9月～2004年4月,15例行先天性心脏病手术治疗的婴幼儿,在体外循环转流停止后采用Terumo Hc-05超滤器行改良超滤. 结果 l5例患儿均存活,无任何超滤相关并发症.超滤时间(12.6±3.1)min,超滤液量(242.6±109.3)ml.转流中HCT (0.23±0.04)L/L,停机时HCT (0.24±0.02)L/L,超滤结束时HCT (0.31±0.03)L/L. 结论婴幼儿体外循环心脏手术中采用改良超滤能在短时间内有效滤除体内多余水分,有效减轻心肺脑等脏器水肿,促进术后早期恢复.     

常规超滤与改良超滤在婴幼儿体外循环心脏手术中的应用分析

目的总结分析婴幼儿先天性心脏病体外循环心脏手术中超滤的临床经验。方法总结分析2004-02～2008-10进行的13kg以下先天性心脏病手术患儿80例的临床资料并随机分组:常规超滤组(CUF组)30例,改良超滤组(MUF)30例,对照组(无超滤组)20例。分析各组各时期K+、HCT、Hb数据及呼吸机辅助时间,术后应用血管活性药物时间、术后引流量、术后胶体应用量等临床资料。结果改良超滤组超滤停止时,其HCT、Hb均高于停机时,高于常规超滤停止时,差异具有统计学意义(P0.01)。常规超滤组停机时,其HCT、Hb均高于改良超滤组停机时,差异具有统计学意义(P0.01)。在呼吸机辅助时间、血管活性药物应用时间及术后胶体用量等方面,改良超滤组优于常规超滤组及对照组,常规超滤组优于对照组,差异具有统计学意义(P0.01)。3组术后引流量未见明显差异。结论常规超滤及改良超滤能较好的改善婴幼儿体外循环手术后的心肺功能,利于术后恢复。     

零平衡超滤与改良超滤在婴幼儿心脏手术中的联合应用

目的探讨零平衡超滤（ZBUF）和改良超滤（MUF）联合应用于婴幼儿体外循环（CPB）手术中的管理特点及临床效果,以判定二者联合应用的可行性及其临床意义。方法20例复杂先天性心脏病患者,其中男12例,女8例;年龄12．6±7．5个月;体重8．5±3．3kg。选用Gambro FH22型血液超滤器,采用经典MUF途径,CPB期间行ZBUF,CPB结束后行MUF。观察患者血流动力学指标、血气分析、生化离子浓度、炎性介质和血浆胶体渗透压（COP）的变化,同时收集滤液测定白细胞介素8（IL-8）和肿瘤坏死因子α（TNF-α）的浓度。结果所有患者MUF结束时平均动脉压（MAP）明显升高（P=0．001）;血液乳酸、TNF-α和IL-8在ZBUF前、后差异无统计学意义;COP在MUF结束明显升高,与ZBUF结束比较差异有统计学意义（P=0．002）。MUF滤液中TNF-α浓度高于ZBUF滤液（P=0．036）。结论ZBUF与MUF联合应用于婴幼儿CPB手术中有排除炎性因子、改善机体免疫应答的能力;MUF可快速减少体内水分、提高COP和红细胞压积,从而改善心肺功能。     

改良超滤对婴幼儿心内直视术后血液流变学的影响

目的评估改良超滤(MU F)对婴幼儿心内直视术后血液流变学的影响。方法选取需行手术治疗、体重<10kg的室间隔缺损(V SD)合并肺动脉高压(PH)患者22例,按住院号的奇、偶数分为对照组(10例,尾数为奇数者)和实验组(12例,尾数为偶数者)。对照组体外循环(CPB)结束后不行MU F,实验组于CPB停机后行MU F,超滤时间10~15m in,超滤流量10~15m l/m in.kg。分别于术前、CPB停机时、CPB后15m in/MU F结束时、术后2h和24h 5个时间点采集桡动脉血2.5m l,采用M DK-3200双通道全自动血液流变测试分析仪检测血液流变学相关指标的变化。结果实验组MU F结束时血红蛋白、红细胞压积、红细胞计数、屈服应力、血浆粘度、全血高切粘度、全血中切粘度、全血低切粘度、全血高切还原粘度、全血中切还原粘度、全血低切还原粘度和卡松粘度均较对照组CPB后15m in明显升高(P<0.05);红细胞变形指数、红细胞聚集指数各时间点两组间比较差异均无统计学意义(P>0.05)。结论使用MU F可明显提高CPB后患者的血红蛋白、红细胞压积、红细胞计数,婴幼儿CPB后采用MU F,其血液粘度高于未行MU F患者。     

利多卡因对心脏手术后病人早期认知功能障碍发生率的影响

目的评价术中应用利多卡因能否减少冠脉分流手术后病人早期认知功能障碍的发生率。方法118例择期体外循环下行冠状动脉分流术的病人随机分为两组。利多卡因组(n=57)在切开心包后静注利多卡因1.5 mg/kg,继以4 mg/min持续输注至术毕,体外循环预充液中另加4mg/kg;对照组(n=61)给予等量生理盐水。分别在术前1 d和术后第9天对病人进行神经精神功能9项测验。各测验项目术后值与术前值相比功能降低等于或超过全部病人该项目术前值的1个标准差判断该项测验出现术后功能恶化;一个病人有2个或2个以上的测验项目术后出现功能恶化判断该病人发生了术后认知功能障碍。结果 88例病人全部完成手术前后神经精神功能测验,其中对照组45例、利多卡因组43例。术后认知功能障碍发生率对照组为42.2％(19例)、利多卡因组为20.9％(9例),利多卡因组明显低于对照组(P<0.05)。结论术中给予利多卡因可明显降低体外循环下冠脉分流手术后病人早期认知功能障碍的发生率。     

新型超滤技术在婴幼儿体外循环手术中的临床应用

目的探讨新型超滤技术的临床应用和防止和减轻体外循环（CPB）后重要器官损伤的作用，以提高手术治疗效果，减少术后并发症。方法将30例先天性心脏病患者分成两组，改良超滤组（n=15）：常规CPB后应用改良超滤；新型超滤组（n=15）：CPB手术中应用新型超滤方法；观察两组患者血浆中炎症介质浓度、红细胞压积（HCT）、白蛋白浓度、肺功能指标、手术时间和器官功能指标的改变。结果新型超滤组CPB后超滤时间较改良超滤组明显缩短（6．35±1.28minvs．12．45±4．52min，P=0．000）；CPB结束后血浆白细胞介素6（IL-6）、肿瘤坏死因子α（TNF—α）浓度明显低于改良超滤组（292．84±58．23μg／Lvs．383．79±66．24μg／L，P=0．000；13．32±2．31μg／Lvs．16．41±2．65μg／L，P=0．000）；CPB结束后HCT和白蛋白浓度明显高于改良超滤组（0．39＋0．04vs．0．35±0．03，P=0．003；38．32±4．26g／Lvs．34．04±2．83g／L，P=0．003）；术后呼吸机辅助时间和住ICU时间均短于改良超滤组（P〈0．05），重要器官功能损害较改良超滤组轻。结论CPB中采用新型超滤技术，可有效地减少部分炎症介质，浓缩血液，缩短手术时间，减轻重要器官组织的水肿和损伤。     

改良超滤联合常规超滤用于重症心脏瓣膜病患者瓣膜置换术的效果

目的 评价改良超滤联合常规超滤用于重症心脏瓣膜病患者瓣膜置换术的效果.方法 择期行瓣膜置换术的重症心脏瓣膜病患者108例,性别不限,年龄≥18岁,体重50～80kg,采用随机数字表法,将患者随机分为常规超滤绀(CUF组,n=56)和改良超滤联合常规超滤组(CMUF组,n=52).CMUF组于 CPB结束后行改良超滤,流世400 ml/min,超滤时间15～20 min.分别于诱导后(T1)、常规超滤开始(T2)、常规超滤结束(T3)、改良超滤开始(T4)、改良超滤结束(T5)、CPB结束后2 h(T6)、8h(T7)及24 h(T8)时采集动脉血样行血气分析,并测定血浆IL-6和IL-8浓度.计算T5-8时的氧合指数,并记录气道压.记录术中尿量、术后24 h尿量、胸腔引流量、术后呼吸机支持时间、术后血制品使用情况及ICU停留时间.结果 与CUF组比较,CMUF组T5,6时Hct升高,T7,8时氧合指数升高,术后呼吸机支持时间、术后24 h尿量、胸腔引流量和浓缩红细胞用量减少(P＜0.05)、血浆IL-6和IL-8浓度、气道压、术中尿量和ICU停留时间比较差异无统计学意义(P＞0.05).结论 改良超滤联合常规超滤可于重症心脏瓣膜病瓣膜置换术患者,改善术后脏器功能,减少异体输血.     

同种输血可能是心脏术后感染的因素之一

目的：探讨同种输血和输血量与心脏手术后感染的相关性，方法：选择12岁以上心脏病人266例，在静吸复合麻醉、低温心肺转流下行心脏外科手术。根据是否输用同种血和输血量分成三组：A组（n=71）为对照组，无同种输血；B组(n=51）同种输血量≤400ml;C组(n=144）同种输血量≥800ml。对三组病例术后感染情况进行分析比较。结果：A组术后感染2例（2．81％），B组感染12例（23．6％），C组感染37例（25．6％），B、C组感染率显著高于A组（P＜0．01）。结论：同种输血是心脏手术后感染的危险因素之一，但是否是感染独立的相关因素尚需进一步研究。     

改良超滤对婴幼儿先天性心脏病术后肺功能的影响

我们将改良超滤法应用于婴幼儿先天性心脏病 (先心病 )体外循环 ,观测其对术后肺功能的影响 ,现报道如下。临床资料　 1999年 10月至 2 0 0 0年 8月 ,我们连续观测了 30例先心病手术病儿在应用改良超滤前后的肺功能变化。其中男 2 0例 ,女 10例 ;年龄 4个月～ 6岁 ,平均 (1 74±2 18)岁。室间隔缺损 (室缺 )伴肺高压 18例 ,室缺合并动脉导管未闭 6例 ,法洛四联症 4例 ,二尖瓣关闭不全 1例 ,室缺加房间隔缺损 (房缺 ) 1例。手术在全身中度低温 (2 4～ 2 6℃ )体外循环下进行 ,转流 (89 18± 36 91)ｍｉｎ ,主动脉阻断(5 4 2 8± 2 6 0 2 )…     

婴幼儿心脏不停跳心内直视手术的临床分析

近年来，浅低温心脏不停跳技术日益受到重视，但在某些方面存在争议。现就我科开展的婴幼儿心脏不停跳心内直视手术的病例进行总结分析。     

婴幼儿心脏手术后两种改良超滤方法对血流动力学的影响

目的 评估先天性心脏患儿体外循环术后静脉-动脉改良超滤(V-A MUF)和动脉-静脉改良超滤(A-V MUF)两种方法对血流动力学的影响.方法 40例患儿随机均分为两组,分别在体外循环术后行10 min改良超滤.分别在体外循环前、体外循环后、体外循环后10、30 min,记录心率、血压和中心静脉压血流动力学参数和血细胞压积.经食管超声心动图测定左心室后壁收缩期(LVPWs)和舒张期厚度(LVPWd)、舒张末期容积(EDV)、收缩术期容积(ESV)和射血分数(EF)并进行两组比较.结果 V-A MUF患儿在体外循环术后10 min和30 min比术后即刻能维持更好的动脉收缩压.体外循环术后两组患儿EF均显著下降(P<0.05).V-A MUF组EF值在CPB术后10 min(60%)和30 min(46%)较CPB术后即刻显著升高(P<0.001).A-V MUF组EF值无上升.V-A MUF组左心室后壁厚度较A-VMUF有显著改善(P<0.05).两组在围术期血细胞压积差异无统计学意义.结论 静脉-动脉改良超滤是一种安全有效改善患儿心脏术后血流动力学的方法.

Abstract：

Objective Evaluate the effects of venous-arterial modified ultrafiltration on hemodynamics compared to arterial-venous in children undergoing cardiopulmonary bypass (CPB) for repair of congenital heart defects. Methods Forty patients underwent MUF randomly divided into two groups,group V-A MUF (n =20) and group A-V MUF (n =20) for 10 min after CPB. They were studied before CPB, after CPB, 10 min after CPB, and 30 min after CPB. Haemodynamic data including heart rate, blood pressure, central venous pressure and hematocrit were recorded. Transoesophaegeal echocardiography determined left ventricular posterior wall thickness in end-systole ( LVPWs) and end-diastole (LVPWd) , end diastolic volume (EDV) , end systolic volume (ESV) and ejection fraction (EF) were measured and compared in two groups. Results Patients in V-A MUF maintained better systolic arterial blood pressure at 10 min and 30 min compared with 0 min values after CPB. A significant decrease in EF were observed in both groups immediately after CPB ( P < 0.05 ). Significant increase in EF was observed at 10 min (60% ) and 30 min (46% ) after CPB compared with 0 min value after bypass in V-A MUF (P <0.001 ). In A-V MUF, no such increase in EF was observed. EF were significantly higher at 10 min and 30 min in V-A MUF as compared with A-V MUF (P < 0. 001). There was also significant improvement in posterior wall thickness in V-A MUF (P <0.05). Haematocrit values were not different in duration of postoperative between two groups. Conclusion Veno-arterial modified ultrafiltration is a safe and effective method of improving hemodynamics in children following cardiac surgery.     

心脏外科手术中应用自体血回收技术的血液保护效果Meta分析

目的 采用Meta分析评价心脏外科手术中应用血液回收技术的血液保护效果. 方法 计算机检索Cochrane 图书馆、PubMed、Embase、CINAHL以及中国知网数据库.收集关于心脏外科手术使用自体血回收的随机对照试验,按Cochrane 系统评价方法,评价所纳入研究的文献质量,并提取有效数据后采用RevMan 5.1软件进行Meta分析. 结果 纳入11项研究,共计2 046例患者.与对照组比较,应用血液回收技术能够减少围手术期红细胞的使用率[比值比(odda radio,OR)=0.68,95％置信区间(confidence interval,CI)(O.53,0.87)],减少围手术期新鲜冰冻血浆的使用率[OR=1.53,95％CI(1.02,2.31)],围手术期血小板的使用率差异无统计学意义[0R=0.86,95％CI (0.56,1.32)],术后并发症的发生率差异无统计学意义[OR=1.14,95％CI(0.92,1.41)]. 结论 心脏手术中使用自体血回收技术可以减少红细胞和新鲜冰冻血浆的输注,具有一定的血液保护效果,且不会增加术后并发症的发生率.     

Changes in respiratory pattern during continuous positive airway pressure in infants after cardiac surgery

Purpose Spontaneous breathing trials are commonly used in adults to enable smooth weaning from mechanical ventilation. However, few investigations have examined spontaneous breathing tests in infants. We investigated how respiratory patterns of infants changed during continuous positive airway pressure (CPAP) and whether successful extubation followed CPAP.Methods Fifty-one consecutive post—cardiac surgery infants satisfied the following weaning criteria: stable hemodynamics, pH > 7.30, tidal volume > 5ml·kg^–1, and respiratory rate < 50 breaths·min^–1 with pressure control of 10–16cm H₂O. We applied CPAP of 3cm H₂O for 30min to these 51 infants. During CPAP, tidal volume, respiratory rate, and arterial blood gases were measured. CPAP was terminated if the patient showed a sustained increase or decrease in heart rate or blood pressure (>20%), a decrease in arterial oxygen saturation (>5%), agitation, or diaphoresis. After the completion of CPAP, tracheal extubation was performed. We considered extubation successful if no reintubation was required in the ensuing 48h.Results Although hemodynamic and ventilatory variables were unstable for the first 5min, they stabilized after 10min of CPAP. Fifty infants completed the CPAP trial safely. Of these, 46 (92%) underwent successful extubation after the CPAP trial. The failure group (4 infants) showed lower pH, higher arterial carbon dioxide tension, and more rapid shallow breathing during CPAP than the success group.Conclusion After cardiac surgery, when infants recovered stable hemodynamics and spontaneous breathing, the ventilatory pattern and hemodynamics became stable after 10min of CPAP. Ninety-two percent of the patients were successfully extubated following a 30-min CPAP trial.     

术中库血输注对脊柱手术患者血糖的影响

目的 研究术中库血输注对脊柱手术患者血糖的影响.方法 随机选择32例脊柱侧凸后路矫形术患者作为输血组（A组）,20例脊柱侧凸前路松解术患者作为非输血组（B组）.输血组均确定在手术开始2 h后开始输血.记录麻醉诱导后（Ta）、手术开始即刻（T0）、手术1 h（T1）、2 h（T2）、3 h（T3）、4 h（T4）、5 h（T5）7个时间点静脉血血糖值.所输库血为枸橼酸磷酸盐葡萄糖（CPD）-红细胞悬液,存储时间为（10.0±5.6）d,血糖值为（19.8±5.3）mmol/L.结果 （1）Ta至T2期间,两组患者血糖的变化呈逐渐上升趋势,T2至T5期间,B组血糖趋于平稳,A组的血糖进一步升高.（2）A组患者中,有21例（65.6%）输血后即刻血糖值超过了6.4 mmol/L,7例（21.9%）输血后即刻血糖值超过了7.8 mmol/L.结论 术中输注库血可以引起患者血糖的升高.     

Prevention of postoperative pneumothorax in patients undergoing cardiac surgery

BACKGROUND: Postoperative pneumothorax is a potentially fatal complication occurring in approximately 1.4% of patients after cardiac surgical procedures. Prevention of this complication could save lives, morbidity, and money in this large patient population. This study was undertaken to evaluate the effectiveness of a very simple technique to prevent this complication. METHODS: One thousand three hundred and ninety-seven consecutive adult patients undergoing cardiac surgical procedures performed by the author were evaluated. In each patient a 3-cm opening in the mediastinal pleura of any unopened hemithorax was performed to allow communication of the pleural space with the mediastinum. When a hemithorax had been opened for internal mammary harvesting, the usual pleural drain was inserted. A standard, straight mediastinal tube was then placed in routine fashion without any additional tube placement or unusual positioning. The essence of the approach was the establishment of communication of both pleural spaces with the mediastinum in such a way that any air exiting the lung would be able to evacuate through the mediastinal tube. RESULTS: One patient with obstructive lung disease developed a loculated basilar pneumothorax that was treated with chest tube placement. Two patients required maintenance of mediastinal tube drainage for persistent air leak for 7 and 9 days, respectively. No other patients required chest tube placement for pneumothorax. No patient experienced any complication that could be attributed to the small opening in the pleural space. CONCLUSIONS: The technique herein described is a safe and effective method for prevention of postoperative pneumothorax. It adds nothing to the cost of the surgical procedure. The author would recommend that this technique be adopted as a surgical routine.     

Risk analysis of blood transfusion requirements in emergency and elective spinal surgery

Spinal surgery has long been considered to have an elevated risk of perioperative blood loss with significant associated blood transfusion requirements. However, a great variability exists in the blood loss and transfusion requirements of differing patients and differing procedures in the area of spinal surgery. We performed a retrospective study of all patients undergoing spinal surgery who required a transfusion ≥1 U of red blood cells (RBC) at the National Spinal Injuries Unit (NSIU) at the Mater Misericordiae University Hospital over a 10-year period. The purpose of this study was to identify risk factors associated with significant perioperative transfusion allowing the early recognition of patients at greatest risk, and to improve existing transfusion practices allowing safer, more appropriate blood product allocation. 1,596 surgical procedures were performed at the NSIU over a 10-year period. 25.9% (414/1,596) of these cases required a blood transfusion (n = 414). Surgical groups with a significant risk of requiring a transfusion >2 U RBC included deformity surgery (RR = 3.351, 95% CI 1.123–10.006, p = 0.03), tumor surgery (RR = 3.298, 95% CI 1.078–10.089, p = 0.036), and trauma surgery (RR = 2.444, 95% CI 1.183–5.050, p = 0.036). Multivariable logistic regression analysis identified multilevel surgery (>3 levels) as a significant risk of requiring a transfusion >2 U RBC (RR = 4.682, 95% CI 2.654–8.261, p < 0.0001). Several risk factors in the spinal surgery patient were identified as corresponding to significant transfusion requirements. A greater awareness of the risk factors associated with transfusion is required in order to optimize patient management.     

单次注射舒芬太尼在腹部手术与心脏手术患者的药代动力学比较

目的比较舒芬太尼在腹部手术与心脏手术患者的药代动力学特征。方法随机选择腹部手术(A组)与心脏手术(C组)患者各8例,全麻后分别静注舒芬太尼2μg/kg和5μg/kg。采用液相色谱-质谱联用法测定静注舒芬太尼后1、3、5、10、20、30、60、120、240和360 min血浆舒芬太尼浓度,并用3p97药理学程序计算药代动力学参数。结果舒芬太尼药代动力学三指数函数方程:A组为Cp(t)=2.86e-0.824t+0.75e-0.060t+0.14e-0.005t,C组为Cp(t)=18.81e-0.492t+4.35e-0.050t+0.28e-0.003t。A组药代动力学参数P、A、B、t1/2β和AUC分别是C组的6.6、5.8、2.0、1.8和4.6倍(P<0.05或P<0.01);而A组中心分布容积(Vc)和清除率(CL)大于或快于C组(P<0.05或P<0.01)。结论舒芬太尼在腹部手术和心脏手术患者药代动力学均可用三室模型描述,疾病性质、CPB与血液稀释可影响其药代动力学特征,临床用药应根据手术患者的具体情况调整用药剂量以做到用药个体化。     

围术期血液管理减少心脏外科手术中输血

目的回顾性分析围术期血液管理应用于心脏外科手术中减少输血的临床效果。方法本研究为回顾性研究,烟台毓璜顶医院2015年7月至2016年5月和2016年8月至2017年4月接受开胸心脏手术的患者106例,2015年7月至2016年5月的患者为对照组(n=49),采用常规管理;2016年8月—2017年4月的患者为研究组(n=57),采用围术期血液管理。比较两组术前基本信息、术中出血量和输血量,评估应用围术期血液管理的临床效果。结果两组术前红细胞、血红蛋白、血小板水平差异无统计学意义。研究组术中出血量明显少于对照组[(565.8±178.6)ml vs(734.1±278.7)ml,P0.05];研究组输异体红细胞比例明显低于对照组(1.8%vs 28.6%,P0.05);研究组输血浆比例明显低于对照组(10.5%vs 40.8%,P0.05);两组血小板和冷沉淀使用比例差异无统计学意义。结论围术期血液管理应用于心脏外科手术可以有效减少术中出血量,降低异体红细胞和血浆使用率。     

Benefits and risks of red blood cell transfusion in pediatric patients undergoing cardiac surgery

As the number of neonates and young infants undergoing cardiac surgery requiring cardiopulmonary bypass (CPB) increases, red blood cell (RBC) transfusion will continue to be an integral part of the practice of pediatric cardiac anesthesiology. The decision of when to transfuse RBCs to these patients is complex and influenced by multiple factors such as size, presence of cyanotic heart disease, complexity of the surgical procedure, and the hemostatic alterations induced by CPB. The known benefits of RBC transfusion include an increase in the oxygen-carrying capacity of blood, improved tissue oxygenation, and improved hemostasis. Unfortunately, there is no minimum hemoglobin level that serves as a transfusion trigger for all pediatric patients undergoing cardiac surgery. Physiologic signs such as tachycardia, hypotension, low mixed venous oxygen saturation and increased oxygen extraction ratios can provide objective evidence of the need to augment a given hemoglobin level. Nevertheless, the benefits of RBC transfusion must be balanced against its risks and, in recent years, RBC transfusion has been subjected to intense scrutiny. The adverse consequences of RBC transfusion include the transmission of infectious diseases and immune-mediated and nonimmune-mediated complications. Advances in donor selection, infectious disease testing of donated blood, use of leukocyte reduction and irradiation of blood in defined situations have improved the safety of the blood supply in terms of infection transmission. However, a growing number of prospective randomized clinical trials are finding an association between RBC transfusion and an increased risk of morbidity and mortality even with the use of leuko-reduced blood. Thus, it is becoming increasingly important that the decision to transfuse RBCs be made with a thorough understanding of the benefit-to-risk ratio. This review addresses the benefits and risks of RBC transfusion, pertinent data acquired in the setting of congenital cardiac surgery and techniques designed to minimize the need for RBC transfusion.     

Nosocomial infections in infants and children after cardiac surgery

Objective  To identify the incidence, characteristics and risk factors of nosocomial infections (NIs) in infants and children undergoing open heart surgery, a prospective observational study. Methods  One hundred consecutive infants and children < 2 yrs of age undergoing open heart surgery (OHS) between March 2007 and December 2007 were included in the study. Samples for blood, endotracheal and urine culture were drawn daily during intensive care unit (ICU) stay. Cultures from endotracheal tube, central venous catheter, arterial cannula, chest tube, urinary catheter and other invasive lines were also obtained. Centers for Disease Control and Prevention criteria were used for defining NIs. A number of possible risk factors predisposing to NI were analyzed. Results  32% patients developed NI. The NI rate was 49%. Common NIs were bloodstream infection (19%), respiratory tract infection (17%), catheter site infection (7%) and urinary tract infection (6%). Common pathogens were Acinetobacter (22.5%), Pseudomonas aeruginosa (20.4%), Klebsiella pneumoniae (16.3%) and Staphylococcus aureus (12.2%). Major risk factors for NI were length of ICU stay (p < 0.001), duration of intubation (p < 0.001), reintubation (p < 0.001), duration of central venous catheterization (p = 0.001), preoperative congestive heart failure (p = 0.002), tracheostomy (p = 0.003), duration of preoperative stay (p = 0.01), blood transfusion (p = 0.01), preoperative balloon atrial septostomy (p = 0.02), duration of surgery (p = 0.03), surgical complexity score (p = 0.03) and hypothermia (p = 0.03). The mortality rate was 11% with significant association between NI and death (p = 0.002). Conclusion  NIs develop frequently in infants and children after OHS. This study may serve as a reference point for further development and implementation of interventions aimed at reducing NI rates and improving patient outcome.