Prognostic Implications of Quantifying Haemodynamic Support: Looking Beyond a Snapshot Score

Circulation, far from an innocent bystander in pediatric cardiac surgical research

“…4 Second, the prognostic importance of quantifying the postoperative hemodynamic support requirement can also not be overemphasized in this peculiarly predisposed pediatric surgical subset. 5,6 Indeed, a multi-institutional analysis of the Pediatric Cardiac Critical Care Consortium (PC 4 ) by Gaies et al 6 delineated increased odds of poor composite outcome in infants with a high vasoactive-inotropic score (VIS) in the first 24 postoperative hours (OR: 6.5; 95% CI: 2.9-14.6, multivariable logistic regression pvalue = .001). Notably so, the VIS-poor outcome association continued to demonstrate significance post-stratification by age as well as surgical complexity.…”

A Comment on the use of Levosimendan for the Management of Right Ventricular Dysfunction in Patients Undergoing Mitral Valve Surgery

“…While using a summative score helps with analysis, and it is commonly used in research, more detailed documentation of the magnitude and duration of the vasoactive drug therapy in the different study groups would have helped to identify more clearly the contribution of levosimendan. [ 2 ] A more standardised protocol for the use of vasoactive drugs in the study would have likely allowed for more reliable comparisons between the two groups.…”