Authors

• Muhammad Shahzad, Pediatric cardiac Surgical ICU King Faisal Specialist Hospital and Research Center Riyadh - Saudia ArabiaFollow
• Muhammad Bokir, College of medicine Alfaisal University Riyadh - Saudia Arabia
• Haifa Almuhanna, College of medicine King faisal university Riyadh - Saudia Arabia
• Abdulaziz Alanazi, Pediatric cardiac Surgical ICU King Faisal Specialist Hospital and Research Center Riyadh - Saudia Arabia
• Zehra Alabbas, Pediatric cardiac Surgical ICU King Faisal Specialist Hospital and Research Center Riyadh - Saudia Arabia
• Reem Beheri, Pediatric Cardiac Surgical ICU King Faisal Specialist Hospital and Research Center Riyadh - Saudia Arabia
• Yasser Abdulrhman Alheraish, Pediatric cardiac Surgical ICU King Faisal Specialist Hospital and Research Center Riyadh - Saudia Arabia
• Khaled alarwan, Pediatric Cardiac Surgical ICU King Faisal Specialist Hospital and Research Center Riyadh - Saudia Arabia

Outcome and clinical characteristics of diaphragm dysfunction After Pediatric Cardiac Surgery: From Detection to Plication

Abstract

Background:

Diaphragm paralysis (DP) due to phrenic nerve injury is a rare but serious complication of pediatric cardiac surgery (0.3–5% of cases). It presents as an extubation failure or difficulty weaning from ventilation. Early recognition and management are essential.

Objectives:

This study aimed to evaluate the incidence, clinical characteristic and outcome of diaphragm paralysis after heart surgery in children.

Methods:

A retrospective single-center review (2019–2024) was conducted of ultrasound-confirmed DP case. Demographics, surgical details, ventilatory course, interventions, and outcomes were analyzed. Partial and complete DP were compared using multivariate logistic regression to identify predictors.

Results:

Out of 2,280 surgeries, 108 children (4.7%) developed DP, with 75% being infants (median age 6.3 months). Partial paresis happened in 2.9% and complete paralysis in 1.8%. The left side was affected most, 46% of total cases. Children with complete DP were younger (median 5.8 vs 7.4 months, pppp

Conclusion:

Diaphragm paralysis after heart surgery is a serious problem in children, especially infants. Partial paralysis improved with non-invasive ventilation and physiotherapy, but complete paralysis often need surgery. Protecting the phrenic nerve, using early imaging, and the prompt actions may improve the outcome.

Recommended Citation

Shahzad, Muhammad; Bokir, Muhammad; Almuhanna, Haifa; Alanazi, Abdulaziz; Alabbas, Zehra; Beheri, Reem; Alheraish, Yasser Abdulrhman; and alarwan, Khaled (2026) "Outcome and clinical characteristics of diaphragm dysfunction After Pediatric Cardiac Surgery: From Detection to Plication," Journal of the Saudi Heart Association: Vol. 38 : Iss. 1 , Article 14.
Available at: https://doi.org/10.37616/2212-5043.1486

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