Preoperative Neutrophil-Lymphocyte Ratio Can Predict Outcomes for Patients Undergoing Tetralogy of Fallot Repair

Manuel, Valdano; Miana, Leonardo Augusto; Guerreiro, Gustavo Pampolha; Turquetto, Aida Luiza Ribeiro; Santos, Rômullo Medeiros; Fernandes, Natália; Tenório, Davi Freitas; Canêo, Luiz Fernando; Jatene, Fábio Biscegli; Jatene, Marcelo Biscegli

doi:10.21470/1678-9741-2020-0408

Cited by 7 publications

(12 citation statements)

References 29 publications

(71 reference statements)

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“…27 In 2020, we studied 116 children after TOF repair and found that an NLR value > 0.8 was associated with longer ICU (P = .03) and hospital LOS (P = .001). 29 Further evaluation of this group of patients demonstrated that a higher NLR was associated with grade III AKI (P = .040). 33…”

Section: Cyanotic Chdmentioning

confidence: 87%

“…Of 404 cyanosis patients (44.9%) in 6 studies, 24,26,27,29,31,33 210 patients underwent CHD repair and 194 patients underwent surgical palliation (Table 1). A total of 193 patients (50.2%) were noted to have TOF.…”

Section: Prognostic Value Of Nlr In Congenital Heart Surgerymentioning

confidence: 99%

“…[25][26][27][28] It was only in 2021 that 5 more studies were published. [29][30][31][32][33] To date, we have 9 studies including a total of 899 patients with cyanosis (404; 44.9%) and acyanosis patients (495; 55.1%) (Table 1). All the patients demonstrated an association of preoperative NLR with different morbidities, mortality, or survival.…”

Section: Prognostic Value Of Nlr In Congenital Heart Surgerymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…It was associated with adverse outcomes, such as a higher VIS, low cardiac output syndrome (LCOS), AKI, liver dysfunction, longer MV time, longer ICU LOS, total hospital LOS, and mortality. [24][25][26][27][28][29][30][31][32][33] Although it presented promising results, there are still many gaps to be filled, such as the normal value for children, the ideal cutoff value to predict adverse outcomes, the wide variation and its correlation with other biomarkers, and if it is a modifiable risk factor.…”

Section: Introductionmentioning

confidence: 99%

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Neutrophil–Lymphocyte Ratio in Congenital Heart Surgery: What Is Known and What Is New?

Manuel

Miana

Jatene

2022

World J Pediatr Congenit Heart Surg

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Operative mortality after repair of congenital heart disease has improved dramatically over the past few decades. Nevertheless, there is always room for the additional mitigation of complications and mortality. Being able to anticipate adverse outcomes is clearly important, especially when using low-cost and easily accessible resources. The neutrophil–lymphocyte ratio (NLR) is defined as the ratio of the absolute neutrophil to lymphocyte count, which can be easily measured using a regular white blood cell count. Recently, preoperative NLR has been shown to be a predictor of outcomes in patients undergoing congenital heart surgery. Although it presented promising results, there are still many gaps to be filled like the normal value for children, the ideal cutoff value to predict adverse outcomes, the wide variation and its correlation with other biomarkers, and if it is a modifiable risk factor. The aim of this review is to understand the prognostic value of preoperative NLR as a biomarker predictor of outcomes in patients undergoing congenital heart surgery based on previous clinical studies and to propose future directions in order to solve the above-mentioned questions.

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Section: Cyanotic Chdmentioning

confidence: 87%

Section: Prognostic Value Of Nlr In Congenital Heart Surgerymentioning

confidence: 99%

Section: Prognostic Value Of Nlr In Congenital Heart Surgerymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Neutrophil–Lymphocyte Ratio in Congenital Heart Surgery: What Is Known and What Is New?

Manuel

Miana

Jatene

2022

World J Pediatr Congenit Heart Surg

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From heart to gut: Exploring the gut microbiome in congenital heart disease

Liu,

Huang,

et al. 2023

iMeta

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Congenital heart disease (CHD) is a prevalent birth defect and a significant contributor to childhood mortality. The major characteristics of CHD include cardiovascular malformations and hemodynamical disorders. However, the impact of CHD extends beyond the circulatory system. Evidence has identified dysbiosis of the gut microbiome in patients with CHD. Chronic hypoxia and inflammation associated with CHD affect the gut microbiome, leading to alterations in its number, abundance, and composition. The gut microbiome, aside from providing essential nutrients, engages in direct interactions with the host immune system and indirect interactions via metabolites. The abnormal gut microbiome or its products can translocate into the bloodstream through an impaired gut barrier, leading to an inflammatory state. Metabolites of the gut microbiome, such as short‐chain fatty acids and trimethylamine N‐oxide, also play important roles in the development, treatment, and prognosis of CHD. This review discusses the role of the gut microbiome in immunity, gut barrier, neurodevelopment, and perioperative period in CHD. By fostering a better understanding of the cross‐talk between CHD and the gut microbiome, this review aims to contribute to improve clinical management and outcomes for CHD patients.

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The role of the neutrophil–lymphocyte ratio for pre-operative risk stratification of acute kidney injury after tetralogy of Fallot repair

et al. 2021

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Introduction: Acute kidney injury is a risk factor for chronic kidney disease and mortality after congenital heart surgery under cardiopulmonary bypass. The neutrophil–lymphocyte ratio is an inexpensive and easy to measure biomarker for predicting outcomes in children with congenital heart disease undergoing surgical correction. Objective: To identify children at high risk of acute kidney injury after tetralogy of Fallot repair using the neutrophil–lymphocyte ratio. Methods: This single-centre retrospective analysis included consecutive patients aged < 18 years who underwent tetralogy of Fallot repair between January 2014 and December 2018. The pre-operative neutrophil–lymphocyte ratio was measured using the last pre-operative complete blood count test. We used the Acute Kidney Injury Network definition. Results: A total of 116 patients were included, of whom 39 (33.6%) presented with acute kidney injury: 20 (51.3%) had grade I acute kidney injury, nine had grade II acute kidney injury (23.1%), and 10 (25.6%) had grade III acute kidney injury. A high pre-operative neutrophil–lymphocyte ratio was associated with grade III acute kidney injury in the post-operative period (p = 0.04). Patients with acute kidney injury had longer mechanical ventilation time (p = 0.023), intensive care unit stay (p < 0.001), and hospital length of stay (p = 0.002). Conclusion: Our results suggest that the pre-operative neutrophil–lymphocyte ratio can be used to identify patients at risk of developing grade III acute kidney injury after tetralogy of Fallot repair.

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Preoperative Neutrophil-Lymphocyte Ratio Can Predict Outcomes for Patients Undergoing Tetralogy of Fallot Repair

Cited by 7 publications

References 29 publications

Neutrophil–Lymphocyte Ratio in Congenital Heart Surgery: What Is Known and What Is New?

Neutrophil–Lymphocyte Ratio in Congenital Heart Surgery: What Is Known and What Is New?

From heart to gut: Exploring the gut microbiome in congenital heart disease

The role of the neutrophil–lymphocyte ratio for pre-operative risk stratification of acute kidney injury after tetralogy of Fallot repair

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