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Pulmonary complications associated with the treatment of patients with congenital cardiac disease: consensus definitions from the Multi-Societal Database Committee for Pediatric and Congenital Heart Disease

Part of: The International Society for Nomenclature of Paediatric and Congenital Heart Disease (ISNPCHD)

Published online by Cambridge University Press:  01 December 2008

David S. Cooper ,
Jeffrey P. Jacobs ,
Paul J. Chai ,
James Jaggers ,
Paul Barach ,
Robert H. Beekman III ,
Otto Krogmann  and
Peter Manning
David S. Cooper*
Affiliation:
The Congenital Heart Institute of Florida (CHIF), Divisions of Critical Care and Thoracic and Cardiovascular Surgery, All Children’s Hospital and Children’s Hospital of Tampa, University of South Florida College of Medicine, Florida Pediatric Associates and Cardiac Surgical Associates (CSA), Saint Petersburg and Tampa, Florida, United States of America
Jeffrey P. Jacobs
Affiliation:
The Congenital Heart Institute of Florida (CHIF), Divisions of Critical Care and Thoracic and Cardiovascular Surgery, All Children’s Hospital and Children’s Hospital of Tampa, University of South Florida College of Medicine, Florida Pediatric Associates and Cardiac Surgical Associates (CSA), Saint Petersburg and Tampa, Florida, United States of America
Paul J. Chai
Affiliation:
The Congenital Heart Institute of Florida (CHIF), Divisions of Critical Care and Thoracic and Cardiovascular Surgery, All Children’s Hospital and Children’s Hospital of Tampa, University of South Florida College of Medicine, Florida Pediatric Associates and Cardiac Surgical Associates (CSA), Saint Petersburg and Tampa, Florida, United States of America
James Jaggers
Affiliation:
Division of Cardiovascular and Thoracic Surgery, Duke’s Children’s Hospital and Health Centre, Duke University, Durham, North Carolina, United States of America
Paul Barach
Affiliation:
Department of Anaesthesia, University of Utrecht, Utrecht, Netherlands
Robert H. Beekman III
Affiliation:
Division of Cardiology, Cincinnati Children’s Hospital Medical Centre, University of Cincinnati, Cincinnati, Ohio, United States of America
Otto Krogmann
Affiliation:
Paediatric Cardiology – CHD, Heart Centre Duisburg, Duisburg, Germany
Peter Manning
Affiliation:
Division of Cardiothoracic Surgery, Cincinnati Children’s Hospital Medical Centre, University of Cincinnati, Cincinnati, Ohio, United States of America
*
Correspondence to: David S. Cooper, MD, MPH, The Congenital Heart Institute of Florida (CHIF), Clinical Assistant Professor of Pediatrics, University of South Florida, Florida Pediatric Associates, 880 Sixth Street South, Suite 370, St. Petersburg, FL 33701. Tel: 727 767 4375; Fax: 727 767 4951; E-mail: davidscooper@verizon.net
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Abstract

A complication is an event or occurrence that is associated with a disease or a healthcare intervention, is a departure from the desired course of events, and may cause, or be associated with, suboptimal outcome. A complication does not necessarily represent a breech in the standard of care that constitutes medical negligence or medical malpractice. An operative or procedural complication is any complication, regardless of cause, occurring (1) within 30 days after surgery or intervention in or out of the hospital, or (2) after 30 days during the same hospitalization subsequent to the operation or intervention. Operative and procedural complications include both intraoperative/intraprocedural complications and postoperative/postprocedural complications in this time interval.

The MultiSocietal Database Committee for Pediatric and Congenital Heart Disease has set forth a comprehensive list of complications associated with the treatment of patients with congenital cardiac disease, related to cardiac, pulmonary, renal, haematological, infectious, neurological, gastrointestinal, and endocrinal systems, as well as those related to the management of anaesthesia and perfusion, and the transplantation of thoracic organs. The objective of this manuscript is to examine the definitions of operative morbidity as they relate specifically to the pulmonary system. These specific definitions and terms will be used to track morbidity associated with surgical and transcatheter interventions and other forms of therapy in a common language across many separate databases.

As surgical survival in children with congenital cardiac disease has improved in recent years, focus has necessarily shifted to reducing the morbidity of congenital cardiac malformations and their treatment. A comprehensive list of pulmonary complications is presented. This list is a component of a systems-based compendium of complications that will standardize terminology and thereby allow the study and quantification of morbidity in patients with congenital cardiac malformations. Clinicians caring for patients with congenital cardiac disease will be able to use this list for databases, initiatives to improve quality, reporting of complications, and comparing strategies of treatment.

Keywords

Congenital heart diseasequality improvementpatient safetyoutcomesregistryoperative morbiditypaediatricsurgerycongenital abnormalitiescardiac surgical proceduresheartlungmechanical ventilation
Type
Original Article
Information
Cardiology in the Young , Volume 18 , Issue S2: Databases and the assessment of complications associated with the treatment of patients with congenital cardiac disease , December 2008 , pp. 215 - 221
Copyright
Copyright © Cambridge University Press 2008

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