Clinical and Laboratory Predictors for the Development of Low Cardiac Output Syndrome in Infants Undergoing Cardiopulmonary Bypass: A Pilot Study
| Autor: | Jess L. Thompson, Harold M. Burkhart, Suanne M Daves, Kathryn Burge, Arshid Mir, Randall M. Schwartz, Edgardo Szyld, Andrew K. Gormley, Hala Chaaban, Sarah E Drennan, Jeffrey Eckert |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Inotrope
medicine.medical_specialty Heart disease lcsh:Medicine 030204 cardiovascular system & hematology Article law.invention 03 medical and health sciences 0302 clinical medicine law Internal medicine Cardiopulmonary bypass Medicine low cardiac output syndrome 030304 developmental biology 0303 health sciences Receiver operating characteristic business.industry lcsh:R General Medicine Perioperative medicine.disease congenital heart disease Cardiac surgery inflammation Cardiology cardiovascular system Observational study pediatric cardiology Complication business cardiopulmonary bypass |
| Zdroj: | Journal of Clinical Medicine Volume 10 Issue 4 Journal of Clinical Medicine, Vol 10, Iss 712, p 712 (2021) |
| ISSN: | 2077-0383 |
| DOI: | 10.3390/jcm10040712 |
| Popis: | Cardiac surgery employing cardiopulmonary bypass exposes infants to a high risk of morbidity and mortality. The objective of this study was to assess the utility of clinical and laboratory variables to predict the development of low cardiac output syndrome, a frequent complication following cardiac surgery in infants. We performed a prospective observational study in the pediatric cardiovascular ICU in an academic children’s hospital. Thirty-one patients with congenital heart disease were included. Serum levels of nucleosomes and a panel of 20 cytokines were measured at six time points in the perioperative period. Cardiopulmonary bypass patients were characterized by increased levels of interleukin-10, -6, and -1α upon admission to the ICU compared to non-bypass cardiac patients. Patients developing low cardiac output syndrome endured longer aortic cross-clamp time and required greater inotropic support at 12 h postoperatively compared to bypass patients not developing the condition. Higher preoperative interleukin-10 levels and 24 h postoperative interleukin-8 levels were associated with low cardiac output syndrome. Receiver operating characteristic curve analysis demonstrated a moderate capability of aortic cross-clamp duration to predict low cardiac output syndrome but not IL-8. In conclusion, low cardiac output syndrome was best predicted in our patient population by the surgical metric of aortic cross-clamp duration. |
| Databáze: | OpenAIRE |
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