Key result
Aortic cross-clamp duration was the best predictor for the development of low cardiac output syndrome in infants undergoing cardiopulmonary bypass.
Why the study?
Cardiac surgery using cardiopulmonary bypass exposes infants to high morbidity and mortality, prompting the need to assess clinical and laboratory variables to predict low cardiac output syndrome.
Do clinical and laboratory variables predict the development of low cardiac output syndrome in infants undergoing cardiopulmonary bypass?
Observational (n=31)
No
Do clinical and laboratory variables predict the development of low cardiac output syndrome in infants undergoing cardiopulmonary bypass?
In infants undergoing cardiopulmonary bypass, the surgical metric of aortic cross-clamp duration is a better predictor of low cardiac output syndrome than perioperative cytokine levels.
Supports risk stratification for postoperative low cardiac output syndrome in infants; leaves open prospective validation before clinical adoption.
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.
No takes yet. Share an insight, caveat, or question.
Drennan et al. (2021) conducted an observational in Congenital heart disease (n=31). Aortic cross-clamp duration and cytokine levels vs. Patients not developing low cardiac output syndrome was evaluated on Development of low cardiac output syndrome. Aortic cross-clamp duration was the best predictor for the development of low cardiac output syndrome in infants undergoing cardiopulmonary bypass.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: