Multicenter Validation of the Vasoactive-Ventilation-Renal Score as a Predictor of Prolonged Mechanical Ventilation After Neonatal Cardiac Surgery*

Cashen, Katherine; Costello, John M.; Grimaldi, Lisa M.; Gowda, Keshava Murty Narayana; Moser, Elizabeth A. S.; Piggott, Kurt D.; Wilhelm, Michael; Mastropietro, Christopher W.

doi:10.1097/pcc.0000000000001694

Cited by 20 publications

(20 citation statements)

References 29 publications

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“…In a limited number of prior studies, the VVR calculated at 48 hours (12,13) and at 12 hours [14,15] was found superior to admission and peak VVR measurements. We also found that admission measurement was performed poorly according to other measurement points.…”

Section: Discussionmentioning

confidence: 85%

“…In a recent multi-center study involving only newborns, like our study, score calculations were made in the postoperative 12-hour period, and the VVR score was found to be superior in determining prolonged MV duration (determined as > 96 hours in this study) compared to VIS, VI, and serum lactate. In this study, the cutoff value was expressed as 35 [15].…”

Section: Discussionmentioning

confidence: 99%

“…Especially, postoperative timing and cut-off values of VVR score for efficient prediction of prognosis in neonates are uncertain. In the most recent multicenter retrospective study involving only newborns, it was found that the postoperative twelfth-hour VVR score was more effective in predicting the prolonged mechanical ventilation (MV) duration compared to other indices, Society of Thoracic Surgeons -European Association for Cardio-Thoracic Surgery Congenital Heart Surgery (STAT) Mortality Categories and cardiopulmonary bypass (CPB) duration [15].…”

Section: Introductionmentioning

confidence: 99%

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Validation of the Vasoactive-Ventilation-Renal Score for Neonatal Heart Surgery

Zübarioğlu¹,

Yildirim²,

Zeybek³

et al. 2021

Cureus

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Objectives: We aimed to validate the vasoactive-ventilation-renal (VVR) score and to compare it with other indices as a predictor of outcome in neonates recovering from surgery for critical congenital heart disease. We also sought to determine the optimal time at which the VVR score should be measured.Methods: We retrospectively reviewed neonates recovering from cardiac surgery between July 2017 and June 2020. The VVR score was calculated at admission, 24, 48, and 72 hours postoperatively. Max values, defined as the highest of the four scores, were also recorded. The main end result of interest was a composite outcome which included prolonged intensive care unit stay and mortality. Receiver operating characteristic curves were generated, and areas under the curve with 95% confidence intervals were calculated for all time points. Multivariable logistic regression modeling was also performed.Results: We reviewed 73 neonates and 21 of them showed composite outcomes. The area under the curve value for VVR score as a predictor of composite outcome was greatest at postoperative 72-hour max (AUC= 0.967; 95% confidence interval, (0.927-1). On multivariable regression analysis, the VVR max 72 hours remained a strong independent predictor of prolonged ICU stay and mortality (odds ratio, 1.452; 95% confidence interval, 1.036-2.035).Conclusions: We validated the utility of the VVR score in neonatal cardiac surgery for critical congenital heart disease. The VVR follow-up in postoperative 72 hours is superior to other indices and especially the maximum VVR value is a potentially powerful clinical tool to predict ICU stay and mortality.

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Validation of the Vasoactive-Ventilation-Renal Score for Neonatal Heart Surgery

Zübarioğlu¹,

Yildirim²,

Zeybek³

et al. 2021

Cureus

View full text Add to dashboard Cite

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“…2 Several data-driven predictors of outcomes have also been developed and validated, such as the Vasoactive Inotropic Score (VIS) and Ventilation Index (VI), but are primarily utilized in research and have subjective variability. 3,4 A number of studies this year focused on utilizing current and novel biomarkers as predictors of adverse outcomes in patients undergoing congenital heart surgery.…”

Section: Predictors Of Outcomes In Congenital Cardiac Surgerymentioning

confidence: 99%

The Year in Review: Anesthesia for Congenital Heart Disease 2019

Houska

Schwartz

2020

Semin Cardiothorac Vasc Anesth

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“…The vasoactive-ventilation-renal (VVR) score is a novel disease severity index which includes components reflecting cardiovascular, pulmonary, and renal function. Recently, the usefulness of the VVR score in pediatric patients undergoing cardiac surgery has been reported (2,3). In some studies (4,5), the VVR score was shown to be predictive in particular of a prolonged length of stay (PLOS) in the intensive care unit (ICU).…”

Section: Introductionmentioning

confidence: 99%

Using Vasoactive-Ventilation-Renal Score in Pediatric Heart Failure Cases as a Predictor of an Extended Intensive Care Unit Stay

Choi¹,

Park²

2021

Iran J Pediatr

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Background: The vasoactive-ventilation-renal (VVR) score is a disease severity index for predicting outcomes of pediatric patients receiving cardiac surgeries. We investigated whether the VVR score on admission can predict the length of stay (LOS) in the pediatric intensive care unit (PICU) in children diagnosed with heart failure (HF). Methods: Medical records were reviewed for pediatric HF cases between January 2010 and December 2016. We calculated the VVR score using the electronic data, including measurements obtained at the time of admission and analyzed the correlation between the VVR score and prolonged LOS (PLOS). A PLOS was defined by a longer stay than the median duration for the surviving cases. Results: A total of 113 pediatric HF cases were reviewed, of which 96 cases were finally included in the study. The median [IQR] LOS was 12 [6, 22] days. The use of a mechanical ventilator and extracorporeal membrane oxygenation (ECMO) were associated with PLOS. The area under the curve (AUC) of the vasoactive-inotropic score (VIS), VVR score, lactic acid level, and brain natriuretic peptide (BNP) for evaluating the association with mechanical ventilator or ECMO use was 0.682 (P = 0.006), 0.823 (P < 0.001), 0.683 (P = 0.006), and 0.783 (P < 0.001), respectively. In multivariable logistic regression analysis, the VVR score was the only significant parameter for predicting PLOS. Conclusions: The VVR score on admission to the PICU is predictive for mechanical ventilator or ECMO use, which correlates with a PLOS. Therefore, the VVR score at PICU admission in children with HF is a useful LOS marker.

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Multicenter Validation of the Vasoactive-Ventilation-Renal Score as a Predictor of Prolonged Mechanical Ventilation After Neonatal Cardiac Surgery*

Abstract: In this multicenter cohort of neonates who underwent cardiac surgery, the Vasoactive-Ventilation-Renal score was a reliable predictor of postoperative outcome and outperformed more traditional measures of disease complexity and severity.

Cited by 20 publications

References 29 publications

Validation of the Vasoactive-Ventilation-Renal Score for Neonatal Heart Surgery

Validation of the Vasoactive-Ventilation-Renal Score for Neonatal Heart Surgery

The Year in Review: Anesthesia for Congenital Heart Disease 2019

Using Vasoactive-Ventilation-Renal Score in Pediatric Heart Failure Cases as a Predictor of an Extended Intensive Care Unit Stay

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