Cardiac Biomarkers of Low Cardiac Output Syndrome in the Postoperative Period After Congenital Heart Disease Surgery in Children

Pérez-Navero, Juan Luís; Torre-Aguilar, María José de la; Rosa, I. Ibarra de la; Gil-Campos, Mercedes; Gómez-Guzmán, Elena; Merino-Cejas, Carlos; Muñoz-Villanueva, María Carmen; Llorente-Cantarero, Francisco J.

doi:10.1016/j.rec.2016.09.011

Cited by 16 publications

(17 citation statements)

References 22 publications

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“…A more recent study has shown that pro-ADM could accurately detect pediatric heart failure [7]. The brain natriuretic peptide and the pro-ANP have been proposed as markers of heart dysfunction, and as prognostic markers for monitoring patients with heart failure, acute coronary syndromes and hypertension [7,8,23–25]. There are many publications about the usefulness of brain natriuretic peptide in children [26], but not about pro-ANP.…”

Section: Introductionmentioning

confidence: 99%

Prognostic value of biomarkers after cardiopulmonary bypass in pediatrics: The prospective PANCAP study

et al. 2019

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Objective To assess the usefulness of procalcitonin, pro-adrenomedullin and pro-atrial natriuretic peptide as predictors of need for mechanical ventilation and postoperative complications (need for inotropic support and bacterial infection) in critically ill pediatric patients after cardiopulmonary bypass. Design A prospective, observational study Setting Pediatric intensive care unit. Patients Patients under 18 years old admitted after cardiopulmonary bypass. Measuraments and main results Serum levels of procalcitonin, pro-adrenomedullin and pro-atrial natriuretic peptide were determined immediately after bypass and at 24–36 hours. Their values were correlated with the need for mechanical ventilation, inotropic support and bacterial infection. One hundred eleven patients were recruited. Septal defects (30.6%) and cardiac valve disease (17.1%) were the most frequent pathologies. 40.7% required mechanical ventilation, 94.6% inotropic support and 15.3% presented invasive bacterial infections. Pro-adrenomedullin and pro-atrial natriuretic peptide showed significant high values in patients needing mechanical ventilation. Cut-off values higher than 1.22 nmol/L and 215.3 pmol/L, respectively for each biomarker, may indicate need for mechanical ventilation with an AUC of 0.721 and 0.746 at admission and 0.738 and 0.753 at 24–36 hours, respectively but without statistical differences. Pro-adrenomedullin and procalcitonin showed statistically significant high values in patients with bacterial infections. Conclusions After bypass, pro-adrenomedullin and pro-atrial natriuretic peptide are suitable biomarkers to predict the need for mechanical ventilation. Physicians should be alert if the values of these markers are high so as not to progress to early extubation. Procalcitonin is useful for predicting bacterial infection. This is a preliminary study and more clinical studies should be done to confirm the value of pro-adrenomedullin and pro-atrial natriuretic peptide as biomarkers after cardiopulmonary bypass.

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Section: Introductionmentioning

confidence: 99%

Prognostic value of biomarkers after cardiopulmonary bypass in pediatrics: The prospective PANCAP study

et al. 2019

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“…The patients were classified according to whether they developed LCOS after corrective surgery (LCOS group and non-LCOS group). LCOS was diagnosed when two or more of the following criteria were met ( 6 , 8 , 9 ): tachycardia (heart rate >90th percentile of normal), hypotension (systolic blood pressure < p 5 for age and sex), oliguria (urine output <1 mL/kg per hour lasting more than 2 h), peripheral skin temperature to core body temperature difference of >7°C, a continuously increased lactic acid level (change rate >0.75 mmol/L per hour), central venous oxygen saturation (ScvO2) <0%, left ventricular ejection fraction as determined by Doppler echocardiography <40%, and a first 24 h peak vasoactive-inotropic score (VIS) ≥20.…”

Section: Methodsmentioning

confidence: 99%

“…Du et al found that the CPB temperature, myocardial protection with histidine-tryptophan-ketoglutarate, and postoperative application of a residual shunt were independent risk predictors of LCOS in children older than 3 months ( 4 ). Additionally, a small number of cytokines, such as the preoperative neutrophil-lymphocyte ratio, postoperative mid-regional pro-adrenomedullin (MR-proADM) and postoperative cardiac troponin I (cTn-I), have been reported as risk factors in children who presented with LCOS after cardiac surgery ( 5 , 6 ). However, the risk predictors of LCOS in infants following CHD surgery under CPB are still uncertain.…”

Section: Introductionmentioning

confidence: 99%

Predictors of Low Cardiac Output Syndrome in Infants After Open-Heart Surgery

Zou

Wang

et al. 2022

Front. Pediatr.

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ObjectiveTo evaluate the predictors of low cardiac output syndrome (LCOS) in infants with congenital heart disease (CHD) after cardiopulmonary bypass (CPB).Study designA total of 217 infants were enrolled and classified according to whether they developed LCOS after cardiac surgery. Each infant's preoperative and intraoperative clinical variables were collected.ResultsThe incidence of LCOS was 28.11% in our study. The univariate analysis showed that the LCOS group was younger than the non-LCOS group (25.69 ± 25.01 days vs. 44.45 ± 26.97 days, P < 0.001), with a higher proportion of neonates (60.7 vs. 27.6%, P < 0.001) and a higher proportion of patients with a RACHS-1 score ≥4 (50.8 vs. 17.9%, P < 0.001). A lower weight (3.70 ± 0.74 vs. 4.23 ± 1.10 kg, P = 0.001), longer ACC time (61.96 ± 21.44 min vs. 41.06 ± 18.37 min, P < 0.001) and longer CPB time (131.54 ± 67.21 min vs. 95.78 ± 62.67 min, P < 0.001) were found in the LCOS group. The levels of free triiodothyronine (FT3) (4.55 ± 1.29 pmol/L vs. 5.18 ± 1.42 pmol/L, P = 0.003) and total triiodothyronine (TT3) (1.80 ± 0.56 nmol/L vs. 1.98 ± 0.54 nmol/L, P = 0.026) were also lower in the LCOS group. The multivariate binary logistic regression analysis and receiver operating characteristic (ROC) indicated that the ACC time, FT3 level and body weight were independent predictors of LCOS.ConclusionsIn our patient population, we first propose that preoperative FT3 can predict the occurrence of postoperative LCOS. ACC time, FT3 level and body weight are independent predictors of LCOS and maybe helpful in reducing the incidence of postoperative LCOS in the future.

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“…(18) çalışmalarında, SvO 2 ≥0.65 ve Pv-aCO 2 <6 mmHg olan hastalarda doku hipoksisi gelişmediğini, mekanik ventilasyon ve yoğun bakımda kalış sürelerinin daha kısa olduğunu bildirmişlerdir. Kalp tipi yağ asidi bağlayıcı protein (H-FABP) son yıllarda en erken yükselen özgün bir biyobelirteç olarak karşımıza çıkmakta ve direkt kardiyak olaylarla ilişkilendirilirken (19) , copeptin de DKD'sini belirlemede özellikle çocuk hastalarda yeni biyobelirteç olarak tanımlanmaktadır (20,21) . Düşük Hb değerleri (Hb<7 g dl -1 ) (22) ve lenfosit değerleri de immün sistemi etkileyerek ile DKD gelişimini artırmaktadır (23) .…”

Section: Laboratuvar Tanı Testleriunclassified

Low Cardiac Output Developed After Open Cardiac Surgery

Özyılkan¹

2020

jarss

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Kalbin dakikada pompaladığı kan hacmi olarak tanımlanan kalp debisi kardiyak performansın değerlendirilmesinde göz önüne alınan en önemli hemodinamik parametrelerden biridir. Açık kalp cerrahisi sonrası hemodinaminin korunması ve yeterli kardiyak performansın sağlanması her zaman kolay olmayabilir. Düşük kalp debisi (DKD) de kardiyak cerrahi sonrası görülebilen ve ciddi hemodinamik değişikliklere yol açarak erken ve geç dönem mortalite ve morbiditeyi artıran durumlardan biridir. Bu derlemede, literatürler eşliğinde DKD'nin öneminin ve yönetiminin gözden geçirilmesi amaçlanmıştır.

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Cardiac Biomarkers of Low Cardiac Output Syndrome in the Postoperative Period After Congenital Heart Disease Surgery in Children

Cited by 16 publications

References 22 publications

Prognostic value of biomarkers after cardiopulmonary bypass in pediatrics: The prospective PANCAP study

Prognostic value of biomarkers after cardiopulmonary bypass in pediatrics: The prospective PANCAP study

Predictors of Low Cardiac Output Syndrome in Infants After Open-Heart Surgery

Low Cardiac Output Developed After Open Cardiac Surgery

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