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Clinical and Laboratory Predictors for the Development of Low Cardiac Output Syndrome in Infants Undergoing Cardiopulmonary Bypass: A Pilot Study

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...

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Autores principales: Drennan, Sarah E., Burge, Kathryn Y., Szyld, Edgardo G., Eckert, Jeffrey V., Mir, Arshid M., Gormley, Andrew K., Schwartz, Randall M., Daves, Suanne M., Thompson, Jess L., Burkhart, Harold M., Chaaban, Hala
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7916966/
https://www.ncbi.nlm.nih.gov/pubmed/33670210
http://dx.doi.org/10.3390/jcm10040712
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author Drennan, Sarah E.
Burge, Kathryn Y.
Szyld, Edgardo G.
Eckert, Jeffrey V.
Mir, Arshid M.
Gormley, Andrew K.
Schwartz, Randall M.
Daves, Suanne M.
Thompson, Jess L.
Burkhart, Harold M.
Chaaban, Hala
author_facet Drennan, Sarah E.
Burge, Kathryn Y.
Szyld, Edgardo G.
Eckert, Jeffrey V.
Mir, Arshid M.
Gormley, Andrew K.
Schwartz, Randall M.
Daves, Suanne M.
Thompson, Jess L.
Burkhart, Harold M.
Chaaban, Hala
author_sort Drennan, Sarah E.
collection PubMed
description 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.
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spelling pubmed-79169662021-03-01 Clinical and Laboratory Predictors for the Development of Low Cardiac Output Syndrome in Infants Undergoing Cardiopulmonary Bypass: A Pilot Study Drennan, Sarah E. Burge, Kathryn Y. Szyld, Edgardo G. Eckert, Jeffrey V. Mir, Arshid M. Gormley, Andrew K. Schwartz, Randall M. Daves, Suanne M. Thompson, Jess L. Burkhart, Harold M. Chaaban, Hala J Clin Med Article 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. MDPI 2021-02-11 /pmc/articles/PMC7916966/ /pubmed/33670210 http://dx.doi.org/10.3390/jcm10040712 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Drennan, Sarah E.
Burge, Kathryn Y.
Szyld, Edgardo G.
Eckert, Jeffrey V.
Mir, Arshid M.
Gormley, Andrew K.
Schwartz, Randall M.
Daves, Suanne M.
Thompson, Jess L.
Burkhart, Harold M.
Chaaban, Hala
Clinical and Laboratory Predictors for the Development of Low Cardiac Output Syndrome in Infants Undergoing Cardiopulmonary Bypass: A Pilot Study
title Clinical and Laboratory Predictors for the Development of Low Cardiac Output Syndrome in Infants Undergoing Cardiopulmonary Bypass: A Pilot Study
title_full Clinical and Laboratory Predictors for the Development of Low Cardiac Output Syndrome in Infants Undergoing Cardiopulmonary Bypass: A Pilot Study
title_fullStr Clinical and Laboratory Predictors for the Development of Low Cardiac Output Syndrome in Infants Undergoing Cardiopulmonary Bypass: A Pilot Study
title_full_unstemmed Clinical and Laboratory Predictors for the Development of Low Cardiac Output Syndrome in Infants Undergoing Cardiopulmonary Bypass: A Pilot Study
title_short Clinical and Laboratory Predictors for the Development of Low Cardiac Output Syndrome in Infants Undergoing Cardiopulmonary Bypass: A Pilot Study
title_sort clinical and laboratory predictors for the development of low cardiac output syndrome in infants undergoing cardiopulmonary bypass: a pilot study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7916966/
https://www.ncbi.nlm.nih.gov/pubmed/33670210
http://dx.doi.org/10.3390/jcm10040712
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