Journals / Türk Kardiyoloji Derneği Arşivi / 2020 / Cilt: 48 - Sayı: 5

Low cardiac output syndrome score to evaluate postoperative cardiac surgery patients in a pediatric intensive care unit

Çocuk yoğun bakım ünitesinde kardiyak cerrahi sonrası hastaların değerlendirilmesinde kullanılan düşük kardiyak debi sendromu skorlaması

Pages
504–513
Publication Date
2022-11-06
DOI
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AI Summary & Key Takeaways

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⚡ TL;DR(Too Long; Didn't Read)

Conclusion: The objective of this study was to draw attention to the potential use of a common language in the care of critical pediatric patients undergoing cardiac surgery with a previously defied scoring method that includes parameters indicating poor perfusion in the patient

📌 3 Key Takeaways

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Objective & Hypothesis:Objective: There is no clear consensus regarding the defiition of low cardiac output syndrome (LCOS) or the follow-up of this patient group.
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Key Findings & Data:Methods: A total of 54 patients were prospectively evaluated after cardiac surgery.
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Conclusion & Impact:Conclusion: The objective of this study was to draw attention to the potential use of a common language in the care of critical pediatric patients undergoing cardiac surgery with a previously defied scoring method that includes parameters indicating poor perfusion in the patient
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Objective: There is no clear consensus regarding the defiition of low cardiac output syndrome (LCOS) or the follow-up of this patient group. Given this lack of a clinical defiition, the aim of this study was to use a LCOS score (LCOSs) similar to the low cardiac output score previously presented in the literature and evaluate the relationship between a high LCOSs and poor clinical outcome. Methods: A total of 54 patients were prospectively evaluated after cardiac surgery. The LCOSs was used to evaluate the deve-lopment of low cardiac output. Each parameter was scored as 1 point. The score was calculated every hour for 24 hours postoperatively and the highest score was recorded as the peak score (pLOCSs). The LOCSs at the time of admission to the pediatric intensive care unit, at the 4th, 8th, and 16th hour were recorded and a cumulative score (cLOCSs) score was calculated. Results: The mean age of the patients was 49.40±53.15 months and 24.07% had LOCS. In the group with LCOS, the cLOCSs, vasoactive-ınotropic score (VIS), lactate mean, aortic clamp time, and the total cardiopulmonary bypass time were signifiantly higher. In this study, a signifiant and positive correlation was found between the cLOCSs and pLOCSs and the length of hospital stay, length of stay in the pediatric intensive care unit, VIS, lactate mean, and aortic clamp duration. Conclusion: The objective of this study was to draw attention to the potential use of a common language in the care of critical pediatric patients undergoing cardiac surgery with a previously defied scoring method that includes parameters indicating poor perfusion in the patient

Özet

Amaç: Düşük kardiyak debi sendromu (DKDS) tanımlanmasıve bu hasta grubunun takibi ile ilgili net bir fiir birliği bulunmamaktadır. Bu klinik tanımlama eksikliğinden yola çıkarak, hastaların izleminde daha önce literatüre sunulmuş olan düşük kardiyak debi skoruna benzer bir DKDS skoru (DKDSs) kullandık veyüksek DKDSs ile kötü klinik seyir ile ilişkisini değerlendirmeyiamaçladık.Yöntemler: Kardiyak cerrahi uygulanmış 54 hasta postoperatif dönemde ileriye dönük olarak incelendi. Düşük kardiyakdebi gelişimini değerlendirmek için DKDSs kullanıldı. Her parametre 1 puan olacak şekilde skorlama yapıldı. DKDS skorupostoperatif 24 saat boyunca saatlik hesaplandı ve en yüksekskor tepe skoru (tDKDSs) olarak kaydedildi. Çocuk yoğun bakım ünitesine başvuru anında, 4., 8. ve 16. saatteki DKDSskaydedildi ve skorların toplamından oluşan bir kümülatif skor(kDKDSs) hesaplandı.Bulgular: Ortalama yaş 49.40±53.15 ay, DKDS oranı %24.07idi. DKDS gelişen grupta kDKDSs, tDKDSs, vazoaktif inotropikskor (VİSt), laktat ortalaması, aort klemp ve total kardiyopulmoner baypas süreleri anlamlı olarak yüksekti. Çalışmamızda,kDKDSs ve tDKDSs ile hastane yatış süresi, çocuk yoğun bakımda yatış süresi, VİSt, laktat ortalaması, aort klemp süresiarasında anlamlı ve pozitif korelasyon saptandı.Sonuç: Amacımız hastada kötü perfüzyonu gösteren parametreleri içeren ve daha önce tanımlanmış olan bir skorlama ilekardiyak cerrahi geçiren kritik çocuk hasta bakımında ortak birdil kullanımına dikkat çekmekti. Geniş hasta grupları ile yapılacak bir çalışmanın ülkemizde postoperatif kardiyak cerrahi hastalarında kullanılabilecek bir skor gelişimi için önemli olacağınıdüşünmekteyiz.

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Cite This Article

ASLAN, N., YILDIZDAŞ, D., GÖÇEN, U., ERDEM, S., YÖNTEM, A., SERTDEMİR, Y., HOROZ, Ö. Ö., DEMİR, F. (2022). Low cardiac output syndrome score to evaluate postoperative cardiac surgery patients in a pediatric intensive care unit. Türk Kardiyoloji Derneği Arşivi, Cilt: 48 - Sayı: 5, 504–513. https://ajindex.com/articles/632007

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References (13)

  1. Parr GV, Blackstone EH, Kirklin JW. Cardiac performance and mortality early after intracardiac surgery in infants and young children. Circulation 1975;51:867–74
  2. Bohn D. Objective assessment of cardiac output in infants after cardiac surgery. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2011;14:19–23
  3. Hoffman TM, Wernovsky G, Atz AM, Kulik TJ, Nelson DP, Chang AC, et al. Effiacy and safety of milrinone in preventing low cardiac output syndrome in infants and children after corrective surgery for congenital heart disease. Circulation 2003;107:996–1002
  4. Wernovsky G, Wypij D, Jonas RA, Mayer JE Jr, Hanley FL, Hickey PR, et al. Postoperative course and hemodynamic profie after the arterial switch operation in neonates and infants. A comparison of low-flw cardiopulmonary bypass and circulatory arrest. Circulation 1995;92:2226–35
  5. Ma M, Gauvreau K, Allan CK, Mayer JE Jr, Jenkins KJ. Causes of death after congenital heart surgery. Ann Thorac Surg 2007;83:1438–45
  6. Jones B, Hayden M, Fraser JF, Janes E. Low cardiac output syndrome in children. Curr Anes Crit Care 2005;16:347–58
  7. Tibby SM, Hatherill M, Marsh MJ, Murdoch IA. Clinicians’ abilities to estimate cardiac index in ventilated children and infants. Arch Dis Child 1997;77:516–8
  8. Tweddell JS, Ghanayem NS, Mussatto KA, Mitchell ME, Lamers LJ, Musa NL, et al. Mixed venous oxygen saturation monitoring after stage 1 palliation for hypoplastic left heart syndrome. Ann Thorac Surg 2007;84:1301–10
  9. Ulate KP, Yanay O, Jeffries H, Baden H, Di Gennaro JL, Zimmerman J. An Elevated Low Cardiac Output Syndrome Score Is Associated With Morbidity in Infants After Congenital Heart Surgery. Pediatr Crit Care Med 2017;18:26–33
  10. Gaies MG, Gurney JG, Yen AH, Napoli ML, Gajarski RJ, Ohye RG, et al. Vasoactive-inotropic score as a predictor of morbidity and mortality in infants after cardiopulmonary bypass. Pediatr Crit Care Med 2010;11:234–8
  11. Ravishankar C, Tabbutt S, Wernovsky G. Critical care in cardiovascular medicine. Curr Opin Pediatr 2003;15:443–53
  12. Butts RJ, Scheurer MA, Atz AM, Zyblewski SC, Hulsey TC, Bradley SM, Graham EM. Comparison of maximum vasoactive inotropic score and low cardiac output syndrome as markers of early postoperative outcomes after neonatal cardiac surgery. Pediatr Cardiol 2012;33:633–8
  13. Charpie JR, Dekeon MK, Goldberg CS, Mosca RS, Bove EL, Kulik TJ. Serial blood lactate measurements predict early outcome after neonatal repair or palliation for complex