Predictive Value of Vasoactive-inotropic Score for Mortality in Newborns Undergoing Cardiac Surgery

Díllí, Dílek; Akduman, Hasan; Örün, Utku Arman; Taşar, Mehmet; Taşoğlu, İrfan; Aydoğan, Seda; Çitli, Rümeysa; Tak, Sercan

doi:10.1007/s13312-019-1639-7

Cited by 13 publications

(10 citation statements)

References 22 publications

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“…In order to have a more accurate assessment, the Vasoactive-inotropic score (VIS) was calculated for each group. The VIS is usually used in ICUs to scale the amount of vasoactive and inotropic support and to evaluate the outcome after infant cardiac surgery ( 15 , 16 ) or in pediatric sepsis ( 17 ).…”

Section: Resultsmentioning

confidence: 99%

Neonatal intensive care unit on‑site surgery for congenital diaphragmatic hernia

et al. 2022

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The present study presents the experience gained in the Newborn Intensive Care Unit (NICU) of ‘Maria S. Curie’ Emergency Clinical Hospital for Children in Bucharest (Romania) after performing a series of bedside surgery interventions on newborns with congenital diaphragmatic hernia (CDH). We conducted a retrospective analysis of the data for all patients operated on-site between 2011 and 2020, in terms of pre- and post-operative stability, procedures performed, complications and outcomes. An analysis of a control group was used to provide a reference to the survival rate for non-operated patients. The present study is based on data from 10 cases of newborns, surgically operated on, on average, on the fifth day of life. The main reasons for operating on-site included hemodynamical instability and the need to administer inhaled nitric oxide (iNO) and high-frequency oscillatory ventilation (HFOV). There were no unforeseen events during surgery, no immediate postoperative complications and no surgery-related mortality. One noticed drawback was the unfamiliarity of the surgery team with the new operating environment. Our experience indicates that bedside surgery improves the likelihood of survival for critically ill neonates suffering from CDH. No immediate complications were associated with this practice.

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Section: Resultsmentioning

confidence: 99%

Neonatal intensive care unit on‑site surgery for congenital diaphragmatic hernia

et al. 2022

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Section: Discussionmentioning

confidence: 77%

“…In a study investigating the predictive value of VIS values on mortality in pediatric patients undergoing cardiac surgery, higher VIS values were associated with longer-duration mechanical ventilation and higher mortality rates (11). Contrary to the mentioned study, when the VIS value as 15.5 was considered a cut-off (11), no significant relationship between high VIS values and mortality was observed; however, a significant difference in the duration of mechanical ventilation was observed. These results may be related to variations in the approach and management of hemodynamic compromise or congenital heart diseases of different severity, different weaning strategies, different types of comorbid states such as genetic abnormalities.…”

Section: Discussionmentioning

confidence: 77%

Vasoactive Inotropic Score for Predicting Pediatric Tracheostomy

2022

ircmj

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Background: Although tracheostomy is not performed as frequently as in adults, it is also used in children. There is no clear consensus on timing and risk factors, especially in early infancy and in cases who underwent cardiac surgeries. In the early infancy period, pediatric cardiac surgery patients have to receive an inotropic agent after the cardiac surgery due to poor general condition or hemodynamic instability. As a result of prolonged intubation, tracheostomy is required to be performed in some of these patients. Objectives: The present study aimed to investigate the relationship between vasoactive inotropic scores (VIS) and tracheostomy in pediatric cardiac surgery patients. Methods: A total of 47 patients, 21 with tracheostomy and 26 without tracheostomy, who underwent cardiac surgery were included in this retrospective study. The VIS and inotrope score (IS) values were calculated and recorded hourly for 48 h postoperatively. Scores were calculated by multiplying the inotropes infusion rate of the patients with certain coefficients. It was attempted to determine objective formalized models and cut-off values that may benefit the relationship between VIS values and tracheostomy. Results: The median weight was 3,630 g (range, 2,040-13,400), and the median age was 69 days (range, 1-1,081) on the surgery day. The majority (93.6%) of the patients were aged < 1 year. Preoperative C-reactive protein measurements were significantly higher by 50% in patients who underwent tracheostomy (P=0.005). The albumin levels in the tracheostomy group (TG) were low, although not significantly (P=0.057). The VIS values of TG had 50% higher values than the non-tracheostomy group (NTG) (P<0.001). In addition, formula 1 predicted with 57% accuracy that a tracheostomy could be performed (VIS =18.170-0.170* HOUR; P < 0.001), and formula 2 predicted with 72% accuracy that a tracheostomy could not be performed (VIS =17.170-0.170* HOUR; P < 0.001). Hospital stay (P<0.001), mechanical ventilation duration (P<0.001), and the number of ongoing intubation on the 7th day post-surgery were significantly higher in TG. Conclusion: After pediatric cardiac surgery, VIS values can predict tracheostomy status and help intensive care professionals make decisions.

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“…Third, this study only recorded the VIS max within 24 h after surgery, while that at 48 h was not recorded. Some studies ( 3 , 27 ) have shown that the VIS max at 48 h may be more representative of the patient's prognosis. Additional research is needed to better understand the relationship between preoperative 25(OH)D level and VIS max at 48 h after surgery.…”

Section: Discussionmentioning

confidence: 99%

Preoperative Vitamin D Deficiency Is Associated With Higher Vasoactive-Inotropic Scores Following Pediatric Cardiac Surgery in Chinese Children

Dong

Deng

et al. 2021

Front. Pediatr.

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The relationship between vitamin D and cardiovascular health in children remains unclear. Vitamin D deficiency (VDD) is supposed to be a potential risk factor associated with poorer outcomes after congenital heart disease (CHD) surgery. The maximum vasoactive-inotropic use after cardiac surgery is considered to be a good predictor of adverse outcomes. We aimed to assess the correlation between preoperative VDD and the maximum vasoactive-inotropic score (VISmax) at 24 h postoperatively. Nine hundred children with CHD were enrolled in this study, and preoperative total serum 25-hydroxyvitamin D [25(OH)D] concentrations were measured by liquid chromatography-tandem mass spectrometry. Related demographic and clinical characteristics were collected. A total of 490 boys (54.4%) and 410 girls (45.6%) with a mean age of 1 year (range: 6 months-3 years) were enrolled. The median 25(OH)D level was 24.0 ng/mL, with 32.6% of patients having VDD [25(OH)D < 20 ng/mL]. The univariate analysis indicated that VDD [odds ratio (OR): 2.27; 95% confidence interval (CI): 1.48–3.50] is associated with a risk of increased VISmax at 24 h postoperation. Multivariate analysis revealed that VDD (OR: 1.85; 95% CI: 1.09–3.02), a Risk-adjusted Congenital Heart Surgery score of at least three points (OR: 1.55; 95% CI: 1.09–2.19), and cardiopulmonary bypass time (OR: 1.02; 95% CI: 1.01–1.02) were independently associated with an increased VISmax within 24 h after cardiac surgery. VDD in pediatric patients before cardiac surgery is associated with the need for increased postoperative inotropic support at 24 h postoperation.

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Predictive Value of Vasoactive-inotropic Score for Mortality in Newborns Undergoing Cardiac Surgery

Cited by 13 publications

References 22 publications

Neonatal intensive care unit on‑site surgery for congenital diaphragmatic hernia

Neonatal intensive care unit on‑site surgery for congenital diaphragmatic hernia

Vasoactive Inotropic Score for Predicting Pediatric Tracheostomy

Preoperative Vitamin D Deficiency Is Associated With Higher Vasoactive-Inotropic Scores Following Pediatric Cardiac Surgery in Chinese Children

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