Use of a novel vasoactive-ventilation-renal score to predict outcomes after paediatric cardiac surgery

Abstract

The novel 48-h VVR was a robust predictor of outcome following paediatric cardiac surgery and outperformed the VIS and peak postoperative lactate.

The effect of Vasoactive- ventilation- renal score on pediatric heart surgery

“…Eighteen percent had single ventricular physiology. The median RACHS-1 score was 2 [1][2][3][4][5][6]. The main characteristics of the cases are shown in Table 1.…”

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

“…The vasoactive-ventilation-renal (VVR) score is a novel disease severity index that incorporates validated markers of cardiovascular, pulmonary, and renal function. In single center studies, it has been shown to be a robust predictor of outcomes in heterogenous populations of children recovering from surgery for congenital heart disease (8)(9)(10). These studies have included neonates (8)(9)(10), children with cyanotic congenital heart disease (9)(10), children undergoing cardiopulmonary bypass (8)(9)(10), children not undergoing cardiopulmonary bypass (9)(10), and adults with congenital heart disease (10).…”

“…In single center studies, it has been shown to be a robust predictor of outcomes in heterogenous populations of children recovering from surgery for congenital heart disease (8)(9)(10). These studies have included neonates (8)(9)(10), children with cyanotic congenital heart disease (9)(10), children undergoing cardiopulmonary bypass (8)(9)(10), children not undergoing cardiopulmonary bypass (9)(10), and adults with congenital heart disease (10). Most recently, the VVR score obtained at 12 hours postoperatively was shown to be a strong predictor of postoperative hospital length of stay and outperformed more traditional indices of disease complexity and illness severity including STAT mortality category, duration of cardiopulmonary bypass, vasoactive-inotrope score, ventilation index, and serum lactate (10).…”

Vasoactive-Ventilation-Renal Score Predicts Cardiac Care Unit Length of Stay in Patients Undergoing Re-Entry Sternotomy: A Derivation Study

“…A newer severity of injury score, the vasoactive-ventilation-renal (VVR) score [1], addresses dysfunction of the pulmonary and renal systems not previously addressed by the vasoactive inotrope score (VIS) [2]. Calculation of the score is shown in Figure 1.…”

“…The stratification tool is highly predictive of outcome, is simple, and is straight forward to calculate. In the initial study of its application, 48-h VVR was a predictor of prolonged intubation, prolonged use of vasoactive infusions, chest tube drainage, and intensive care unit (ICU) and hospital length of stay (LOS) and outperformed VIS and peak postoperative lactate in a retrospective analysis of infants following congenital heart surgery [1]. Prospective validation by Miletic and colleagues in a heterogeneous population of pediatric patients undergoing cardiac surgery found the 48-h VVR score to be a predictor of outcomes and outperformed VIS [3].…”