Prognostic value of cardiac cycle efficiency in children undergoing cardiac surgery: a prospective observational study

Ding, Heyu; Pan, Shoudong; Li, Hang; Lv, Meng; Luo, Yi; Ouyang, Chuying

doi:10.1016/j.bja.2020.05.042

Cited by 9 publications

(12 citation statements)

References 29 publications

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“…For infracardiac and supracardiac TAPVC, surgeons frequently perform procedures to create an anastomosis between the left atrium and the pulmonary venous confluence. Although TAPVC can manifest beyond the neonatal period, our case demonstrates that surgical repair can still succeed, involving the creation of an anastomosis between the left atrium and the common pulmonary vein 14,18 . Our study found that infracardiac TAPVC had successful surgical outcomes, and there was a low incidence of postoperative complications such as pulmonary hypertension and pulmonary venous obstruction.…”

Section: Discussionmentioning

confidence: 58%

“…Although TAPVC can manifest beyond the neonatal period, our case demonstrates that surgical repair can still succeed, involving the creation of an anastomosis between the left atrium and the common pulmonary vein. 14,18 Our study found that infracardiac TAPVC had successful surgical outcomes, and there was a low incidence of postoperative complications such as pulmonary hypertension and pulmonary venous obstruction. These results are in line with previous studies, and our follow-up evaluations did not reveal any significant issues.…”

Section: Discussionmentioning

confidence: 63%

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Unobstructed infracardiac total anomalous pulmonary venous connection in a 7‐month‐old infant: A rare case report

Shhada,

Nahle,

Hamdar

et al. 2023

Clinical Case Reports

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Key Clinical MessageThis case underscores the importance of early detection and treatment for total anomalous pulmonary venous connection, a rare congenital heart condition, through comprehensive newborn physical exams and prompt specialist referrals.AbstractTotal anomalous pulmonary venous connection (TAPVC) is a rare form of congenital heart disease that is typically diagnosed in neonates. TAPVC has four subtypes, with the infracardiac type at risk of obstruction. TAPVC is usually diagnosed in newborns but can occur in other age groups. In this case, a 7‐month‐old male with recurrent cyanotic episodes was diagnosed with TAPVC of the infracardiac type using computed tomography angiography. The patient underwent successful surgical repair with a favorable postoperative course and was discharged in stable condition, and further follow‐up was not possible beyond 2 months. This case emphasizes the importance of early recognition and management of this condition to prevent the progression of subsequent complications.

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Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 63%

Unobstructed infracardiac total anomalous pulmonary venous connection in a 7‐month‐old infant: A rare case report

Shhada,

Nahle,

Hamdar

et al. 2023

Clinical Case Reports

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“…[24,41]. The negative value of CCE with no signi cant changes over time in our study (Table 2) indicates the constant rather than worsening condition of cardiac energy expenditure for compensation to maintain cardiovascular homeostasis after the surgery [32,43]. However, CCE can be in uenced by many factors.…”

Section: Ccementioning

confidence: 68%

“…Many reports have found that cardiac dysfunction is associated with longer mechanical ventilation duration, over 12h, 24h, or even longer in comparison to the normal group [4,8,13,32,33], yet a consensus on a de nite concept for prolonged DMV has not been made. DMV as a crucial index for prognosis still needs more study and data collection.…”

Section: Cardiac Function In Predicting Dmvmentioning

confidence: 99%

The predictive value of Pressure Recording Analytical Method for the duration of mechanical ventilation in children undergoing cardiac surgery with an XGboost based machine learning model

Zhang

Wang

et al. 2022

Preprint

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Background：Prolonged mechanical ventilation in children undergoing cardiac surgery is related to the decrease of cardiac output during the postoperative intense care time, which often induced serious complications. Pressure Recording Analytical Method (PRAM) is a minimally invasive system for continuous hemodynamic monitoring, which can timely record the presence of lower cardiac function. This study is aimed to evaluate the predictive value of the several hemodynamic parameters for the duration of mechanical ventilation (DMV).Methods：This retrospective study included 60 children under 1-year-old who underwent cardiac surgery between 2017 and 2021. CI, CCE and dp/dt max derived from PRAM was documented in each patient 0, 4, 8 and 12 hours (T0, T1,T2, T3 and T4 respectively) after admission to the intensive care unit (ICU). A linear mixed model were used to deal with the repeated measurement on hemodynamic data. Correlation analysis and Receiver operating characteristic (ROC) curves were used to show the predictive value. XGBoost machine learning-based mode which produces a decision tree-heat map was used to find the key characteristics of the data in predicting the outcome. Results：There were 35(58%) children in DMV≤24 h group and 25(42%) were in DMV>24h. Prolonged DMV caused longer ICU stays and postoperative hospital stays. Linear mixed model revealed significant time and group effect in CI and dp/dt max. Prolonged DMV also have negative correlations with age, weight, CI at T2 and dp/dt max at T2. dp/dt max outweighing CI were the strongest predictors of prolonged DMV(AUC of ROC: 0.978 vs 0.811, respectively, p<0.01). The XGboost based learning machine model (Balance Accuracy=0.92, AUC of ROC=0.856) suggested that dp/dt max at T2 ≤1.049 or >1.049 in combination with CI at T0 ≤2 or > 2 can predict prolonged DMV.Conclusions：Hemodynamic monitoring in infants with PRAM after the cardiac surgery shows that the cardiac function can predict the prolonged duration of mechanical ventilation. CI measured by PRAM immediately after ICU admission and dp/dt max that 8h later are 2 key factors in predicting prolonged DMV with the application of XGboost based machine learning model.

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“…Cardiac dysfunction is the main risk factor for 80% weaning failure ( 5 ). Han et al and Kadir et al also found that cardiac dysfunction is associated with longer mechanical ventilation duration ( 30 , 31 ). Both the preload and afterload increase due to the decrease in intrathoracic pressure premature in the process of extubation and increase cardiac work and myocardial oxygen consumption.…”

Section: Discussionmentioning

confidence: 95%

The predictive value of pressure recording analytical method for the duration of mechanical ventilation in children undergoing cardiac surgery with an XGBoost-based machine learning model

Wang²,

Zhang³

et al. 2022

Front. Cardiovasc. Med.

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ObjectiveProlonged mechanical ventilation in children undergoing cardiac surgery is related to the decrease in cardiac output. The pressure recording analytical method (PRAM) is a minimally invasive system for continuous hemodynamic monitoring. To evaluate the postoperative prognosis, our study explored the predictive value of hemodynamic management for the duration of mechanical ventilation (DMV).MethodsThis retrospective study included 60 infants who underwent cardiac surgery. Cardiac index (CI), the maximal slope of systolic upstroke (dp/dtmax), and cardiac cycle efficiency (CCE) derived from PRAM were documented in each patient 0, 4, 8, and 12 h (T0, T1, T2, T3, and T4, respectively) after their admission to the intensive care unit (ICU). A linear mixed model was used to deal with the hemodynamic data. Correlation analysis, receiver operating characteristic (ROC), and a XGBoost machine learning model were used to find the key factors for prediction.ResultsLinear mixed model revealed time and group effect in CI and dp/dtmax. Prolonged DMV also have negative correlations with age, weight, CI at and dp/dtmax at T2. dp/dtmax outweighing CI was the strongest predictor (AUC of ROC: 0.978 vs. 0.811, p < 0.01). The machine learning model suggested that dp/dtmax at T2 ≤ 1.049 or < 1.049 in combination with CI at T0 ≤ 2.0 or >2.0 can predict whether prolonged DMV (AUC of ROC = 0.856).ConclusionCardiac dysfunction is associated with a prolonged DMV with hemodynamic evidence. CI measured by PRAM immediately after ICU admission and dp/dtmax 8h later are two key factors in predicting prolonged DMV.

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Prognostic value of cardiac cycle efficiency in children undergoing cardiac surgery: a prospective observational study

Cited by 9 publications

References 29 publications

Unobstructed infracardiac total anomalous pulmonary venous connection in a 7‐month‐old infant: A rare case report

Unobstructed infracardiac total anomalous pulmonary venous connection in a 7‐month‐old infant: A rare case report

The predictive value of Pressure Recording Analytical Method for the duration of mechanical ventilation in children undergoing cardiac surgery with an XGboost based machine learning model

The predictive value of pressure recording analytical method for the duration of mechanical ventilation in children undergoing cardiac surgery with an XGBoost-based machine learning model

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