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Year : 2022  |  Volume : 31  |  Issue : 2  |  Page : 202-207

Paediatric cardiac anaesthesia perspective in komfo anokye teaching hospital kumasi: A 10-year review

1 Department of Anaesthesiology and Intensive Care, School of Medicine and Dentistry, CHS, Kwame Nkrumah University of Science and Technology; Directorate of Anaesthesia and Intensive Care, Komfo Anokye Teaching Hospital, Kumasi, Ghana; Department of Cardiac Anaesthesia and Intensive Care, SAMSRI, Lucknow, Uttar Pradesh, India
2 Department of Surgery, School of Medicine and Dentistry, CHS, Kwame Nkrumah University of Science and Technology Kumasi/Cardiovascular and Thoracic Surgery Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana
3 Department of Public Health, School of Public Health, CHS, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana

Correspondence Address:
Dr. Sanjeev Singh
Department of Cardiacanaesthesia and Intensive Care; SAMSRI, Lucknow, Uttar Pradesh

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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/NJM.NJM_12_22

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Background: Infant mortality due to congenital malformations has an incident rate of 8 cases per 1000 live births. Due to Africa's inadequate health-care systems, congenital cardiac disease (CCD) remains a paediatric health-care issue. CCD patients undergo an open-heart operation (OHO) at the Komfo Anokye Teaching Hospital (KATH) in Kumasi. Aim: This study aimed to compare trends of cardiac anaesthesia protocols before and after 2014 and to assess the efficiency and quality of surgical care provided to children with CCD following the implementation of new cardiac anaesthesia protocols in 2014. Materials and Methods: Groups A and B were represented by the years before and after 2014. This was a retrospective study involving 118 patients who underwent OHO under general anaesthesia from 2007 to 2016 after obtaining Institutional ethical approval. Results: In Groups A and B, the mean length of hospitalization in days and cardiac care unit stay in days were (6.87 ± 3.51 and 4.20 ± 3.66) (P = 0.046) and (3.14 ± 2.37 and 1.96 ± 2.85) (P = 0.382), respectively. In Group B, ultrafast track extubations increased from 7.25% to 39.71% (P = 0.021), while patients mean mechanically ventilation time decreased by 82.34 ± 11.70–23.48 ± 7.94 h (P = 0.018). In the first 48 h, the chest tube's postoperative drainage reduced by 133 ± 28.46–95 ± 20.38 ml (P = 0.018) and haemorrhage leading to re-exploration decreased 11.77%–1.50% (P = 0.019). After 2014, postoperative haemorrhage, the chest tube's drainage, and re-exploration were statistically significantly reduced by tranexamic acid. Conclusions: This ten-year program primarily focused on selecting simple cases and simplifying anaesthesia protocols after 2014. Given the success of our OHO program at KATH Kumasi, there is a need for a paradigm shift to sustain OHO programs in other parts of Africa.

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