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Cardiac Children Hospital Early Warning ScoreVersus the Inadequate Oxygen Delivery Index for the Detection of Early Warning Signs of Deterioration
To assess the utility of the Cardiac Children’s Hospital Early Warning Score (C-CHEWS) in the early detection of deterioration. DESIGN: Single-center longitudinal pilot study. SETTING: Pediatric cardiac ICU (PCICU), Aga Khan University. INTERVENTIONS: C-CHEWS and Inadequate Oxygen Delivery (IDO(2))...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9876003/ https://www.ncbi.nlm.nih.gov/pubmed/36713629 http://dx.doi.org/10.1097/CCE.0000000000000833 |
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author | Khalil, Mujtaba Abbas, Qalab Azhar, Mohammad Kumael Aamir, Faiqa Binte Hashmi, Shiraz Ali, Sadaqat Faiz, Tahira Malik, Mahim Akmal |
author_facet | Khalil, Mujtaba Abbas, Qalab Azhar, Mohammad Kumael Aamir, Faiqa Binte Hashmi, Shiraz Ali, Sadaqat Faiz, Tahira Malik, Mahim Akmal |
author_sort | Khalil, Mujtaba |
collection | PubMed |
description | To assess the utility of the Cardiac Children’s Hospital Early Warning Score (C-CHEWS) in the early detection of deterioration. DESIGN: Single-center longitudinal pilot study. SETTING: Pediatric cardiac ICU (PCICU), Aga Khan University. INTERVENTIONS: C-CHEWS and Inadequate Oxygen Delivery (IDO(2)) Index calculation every 2 hours. PATIENTS: A total of 60 children (0 d to 18 yr old). MEASUREMENTS AND MAIN RESULTS: A single-center longitudinal pilot study was conducted at PCICU. All postoperative extubated patients were assessed and scored between 0 and 11, and these scores were then correlated with the IDO(2) index data available from the T3 platform. Adverse events were defined as a need for cardiopulmonary resuscitation, or reintubation, and death. A total of 920 C-CHEWS and IDO(2) scores were analyzed on 60 patients during the study period. There were 36 males and 24 females, and the median age of the study population was 34 months (interquartile range, 9.0–72.0 mo). Fourteen patients (23.3%) developed adverse events; these included 9 reintubations and 5 cardiopulmonary arrests, resulting in 2 deaths. The area under the curve (AUC) for C-CHEWS scores fell in an acceptable range of 0.956 (95% CI, 0.869–0.992), suggesting an optimal accuracy for identifying early warning signs of cardiopulmonary arrest. Whereas, IDO(2) showed no discriminatory power to detect the adverse events with an AUC of 0.522 (95% CI, 0.389–0.652). CONCLUSIONS: The C-CHEWS tool provides a standardized assessment and approach to deteriorating congenital cardiac surgery patients in recognizing early postoperative deterioration. |
format | Online Article Text |
id | pubmed-9876003 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-98760032023-01-26 Cardiac Children Hospital Early Warning ScoreVersus the Inadequate Oxygen Delivery Index for the Detection of Early Warning Signs of Deterioration Khalil, Mujtaba Abbas, Qalab Azhar, Mohammad Kumael Aamir, Faiqa Binte Hashmi, Shiraz Ali, Sadaqat Faiz, Tahira Malik, Mahim Akmal Crit Care Explor Observational Study To assess the utility of the Cardiac Children’s Hospital Early Warning Score (C-CHEWS) in the early detection of deterioration. DESIGN: Single-center longitudinal pilot study. SETTING: Pediatric cardiac ICU (PCICU), Aga Khan University. INTERVENTIONS: C-CHEWS and Inadequate Oxygen Delivery (IDO(2)) Index calculation every 2 hours. PATIENTS: A total of 60 children (0 d to 18 yr old). MEASUREMENTS AND MAIN RESULTS: A single-center longitudinal pilot study was conducted at PCICU. All postoperative extubated patients were assessed and scored between 0 and 11, and these scores were then correlated with the IDO(2) index data available from the T3 platform. Adverse events were defined as a need for cardiopulmonary resuscitation, or reintubation, and death. A total of 920 C-CHEWS and IDO(2) scores were analyzed on 60 patients during the study period. There were 36 males and 24 females, and the median age of the study population was 34 months (interquartile range, 9.0–72.0 mo). Fourteen patients (23.3%) developed adverse events; these included 9 reintubations and 5 cardiopulmonary arrests, resulting in 2 deaths. The area under the curve (AUC) for C-CHEWS scores fell in an acceptable range of 0.956 (95% CI, 0.869–0.992), suggesting an optimal accuracy for identifying early warning signs of cardiopulmonary arrest. Whereas, IDO(2) showed no discriminatory power to detect the adverse events with an AUC of 0.522 (95% CI, 0.389–0.652). CONCLUSIONS: The C-CHEWS tool provides a standardized assessment and approach to deteriorating congenital cardiac surgery patients in recognizing early postoperative deterioration. Lippincott Williams & Wilkins 2023-01-23 /pmc/articles/PMC9876003/ /pubmed/36713629 http://dx.doi.org/10.1097/CCE.0000000000000833 Text en Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Observational Study Khalil, Mujtaba Abbas, Qalab Azhar, Mohammad Kumael Aamir, Faiqa Binte Hashmi, Shiraz Ali, Sadaqat Faiz, Tahira Malik, Mahim Akmal Cardiac Children Hospital Early Warning ScoreVersus the Inadequate Oxygen Delivery Index for the Detection of Early Warning Signs of Deterioration |
title | Cardiac Children Hospital Early Warning ScoreVersus the Inadequate Oxygen Delivery Index for the Detection of Early Warning Signs of Deterioration |
title_full | Cardiac Children Hospital Early Warning ScoreVersus the Inadequate Oxygen Delivery Index for the Detection of Early Warning Signs of Deterioration |
title_fullStr | Cardiac Children Hospital Early Warning ScoreVersus the Inadequate Oxygen Delivery Index for the Detection of Early Warning Signs of Deterioration |
title_full_unstemmed | Cardiac Children Hospital Early Warning ScoreVersus the Inadequate Oxygen Delivery Index for the Detection of Early Warning Signs of Deterioration |
title_short | Cardiac Children Hospital Early Warning ScoreVersus the Inadequate Oxygen Delivery Index for the Detection of Early Warning Signs of Deterioration |
title_sort | cardiac children hospital early warning scoreversus the inadequate oxygen delivery index for the detection of early warning signs of deterioration |
topic | Observational Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9876003/ https://www.ncbi.nlm.nih.gov/pubmed/36713629 http://dx.doi.org/10.1097/CCE.0000000000000833 |
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