Präoperative Azidose und Entwicklung von Säuglingen nach Operation angeborener Herzfehler
Autor: | L.A. Lisowski, E. J. Meijboom, P.M. Verheijen, Sander Wassink, G.H.A. Visser |
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Rok vydání: | 2010 |
Předmět: |
medicine.medical_specialty
Fetus Receiver operating characteristic Heart disease business.industry Significant difference Prenatal diagnosis medicine.disease Oxygen debt Surgery Internal medicine medicine Cardiology Base excess medicine.symptom Cardiology and Cardiovascular Medicine business Acidosis |
Zdroj: | Herz. 35:358-363 |
ISSN: | 1615-6692 0340-9937 |
Popis: | Prenatal diagnosis has been shown to decrease pre-operative acidosis and might prevent the occurrence of disturbed developmental outcome. The aim of this study is to evaluate parameters for acidosis and their predictive value on developmental outcome in newborns with congenital heart disease. A total of 117 patients requiring surgery for structural heart disease in the first 31 days of life were included. Diagnosis was established either pre- or postnatally. Preoperative values of lactate, pH and base excess levels were compared to the occurrence of disturbed developmental outcome, i.e. an underperformance of more than 10% on the P90 of a standardized Dutch developmental scale. Patients were divided into groups according to blood levels of acidosis parameters, using receiver operating characteristics curves to determine cut-off values for pH, base excess and lactate. No significant difference in developmental outcome was found using values for pH or base excess as a cut-off level. Preoperative lactate values exceeding 6.1 mmol/l resulted in a significant increase in impaired development compared to infants with a pre-operative lactate lower than 6.1 mmol/l: 40.9% vs 15.1% in (p=0.03). Pre-operative lactate values might have a prognostic value on developmental outcome in newborns with congenital heart disease. The limited prognostic value of pH can be explained by the fact that pH can be easily corrected, while lactate better reflects the total oxygen debt experienced by these patients. |
Databáze: | OpenAIRE |
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