Factors associated with prolonged recovery after the arterial switch operation for transposition of the great arteries in infants.

This study aimed specifically to identify the predictors of prolonged recovery after the arterial switch operation for transposition of the great arteries in infants. The clinical records of all infants admitted to the surgical intensive care unit (SICU) between January 2000 and March 2011 after an arterial switch operation were retrospectively reviewed. The cohort was divided into a prolonged recovery group that included all patients who exceeded the 75th percentile for duration of SICU stay and a standard recovery group that included all the remaining patients. Of the 102 patients in the final analysis, 31 experienced prolonged recovery. The median SICU stay was 18 days (range, 14-58 days) for the patients in the prolonged recovery group and only 8 days (range, 5-13 days) for the patients in the standard recovery group. After univariate analysis, a stepwise logistic regression model analysis was used to compare the demographic data as well as the pre-, intra-, and postoperative variables between the two groups. Of all the variables analyzed, high postbypass serum lactate level [odds ratio (OR), 2.610; 95 % confidence interval (CI), 1.464-4.653; p = 0.039], need for larger volume of resuscitation fluid (OR, 3.154; 95 % CI, 1.751-5.682; p = 0.018), and noninfectious pulmonary complication (OR, 2.844; 95 % CI, 1.508-5.363; p = 0.025) were identified as independent risk factors for prolonged recovery among infants undergoing an arterial switch operation for transposition of the great arteries.