CONGRESS ABSTRACT

After cardiac surgery or percutaneous procedures, pediatric patients often remain intubated upon arrival in the intensive care unit. Literature indicates that 3-27% of pediatric patients are not successfully extubated after cardiac surgery. Following extubation, non-invasive respiratory support methods such as High-Flow Nasal Cannula (HFNC) and Non-Invasive Positive Pressure Ventilation (NIPPV) are commonly used for these patients. Both methods offer advantages, yet data are limited and do not clearly demonstrate the superiority of one over the other. Currently, the Cardio-Thoraco-Vascular Anesthesia and Intensive Care Unit of the IRCCS University Hospital of Bologna lacks a shared protocol for post-extubation management of pediatric patients under one year old who undergo cardiac surgery or  percutaneous procedures. The choice of respiratory support is therefore left to the clinical assessment of individual healthcare providers based on patient-specific parameters. Thus, reaching a definitive conclusion on the optimal type of respiratory support for this patient category remains challenging, highlighting the need for further analysis of current intensive care practices. This study aims to analyze the experience of this operating unit to assess which of HFNC and NIPPV is associated with lower rates of extubation failure in pediatric patients with congenital heart disease and to identify the main risk factors that may contribute to extubation failure. To achieve this goal, a retrospective investigation will be conducted, analyzing data collected via paper and electronic medical records (Margherita 3) for all pediatric patients (aged <1 year) with congenital heart disease who underwent corrective procedures between January 1, 2024, and December 31, 2024.  The results will help optimize patient management in the post-extubation phase, with positive clinical and organizational impacts. Regarding potential future implications, the project aims to positively affect reintubation and mortality rates, decrease length of stay in intensive care and general wards, and reduce the incidence of respiratory complications.