Vasoactive Inotropic Score (Vis) Is Associated With Outcome After Infant Cardiac Surgery: A Report of the Pediatric Cardiac Critical Care Consortium (Pc4)

Gaies, Michael; Jeffries, Howard E.; Niebler, Robert A.; Pasquali, Sara K.; Donohue, Janet E.; Yu, Sunkyung; Thiagarajan, Ravi R.

doi:10.1016/s0735-1097(13)60424-6

Cited by 116 publications

(169 citation statements)

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“…• Admission and pre-extubation vasoactive medication requirements o Vasoactive medication requirements were quantified using the vasoactiveinotropic score [14][15][16][17], calculated according to following formula: VIS = dopamine (μg/kg/min) + dobutamine (μg/kg/min) + 100 X epinephrine (μg/kg/min) + 10 X milrinone (μg/kg/min) + 10,000 X vasopressin (U/kg/min) + 100 X norepinephrine (μg/kg/min)…”

Section: Postoperative Datamentioning

confidence: 99%

Extubation Failure after Neonatal Cardiac Surgery: A Multicenter Analysis

Mastropietro

Cashen

Grimaldi

et al. 2017

The Journal of Pediatrics

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Objectives: To describe the epidemiology of extubation failure and identify risk factors for its occurrence in a multicenter population of neonates undergoing surgery for congenital heart disease. Study Design:We conducted a prospective observational study of neonates ≤ 30 days of age who underwent cardiac surgery at seven centers within the United States in 2015. Extubation failure was defined as reintubation within 72 hours of the first planned extubation. Risk factors were identified using multivariable logistic regression analysis and reported as odds ratios (OR) with 95% confidence intervals (CI). Multivariable logistic regression analysis was also conducted to examine the relationship between extubation failure and worse clinical outcome, defined as hospital length-of-stay in the upper 25% or operative mortality.

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Section: Postoperative Datamentioning

confidence: 99%

Extubation Failure after Neonatal Cardiac Surgery: A Multicenter Analysis

Mastropietro

Cashen

Grimaldi

et al. 2017

The Journal of Pediatrics

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“…Inotropic score within the first hour of ≥20 was categorized as high VIS. [11] High lactate level was defined as lactate levels of ≥4.5 mmol/L at least once within the intraoperative period and postoperative first 24 hours. The patients were divided into two groups according to lactate levels measured in arterial blood gas.…”

Section: Methodsmentioning

confidence: 99%

Correlation between serum lactate levels and outcome in pediatric patients undergoing congenital heart surgery

Şahutoğlu

Yaşar

Kocabas

et al. 2018

Turk Gogus Kalp Dama

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ÖZAmaç: Bu çalışmada doğuştan kalp cerrahisi geçiren pediatrik hastalarda perioperatif arteriyal laktat düzeyleri ile mortalite ve morbidite arasında ilişki olup olmadığı araştırıldı.Ça lış m a pla nı: Haziran 2014-Mayıs 2016 tarihleri arasında doğuştan kalp cerrahisi geçiren 236 hasta (121 erkek, 115 kadın; ort. yaş 56.4 ay (median: 42 ay): dağılım, 1 gün-204 ay) retrospektif olarak değerlendirildi. Başlangıçta (arter kanülü uygulandıktan sonra), kardiyopulmoner baypas soğuma ve ısınma fazında, sternum kapatılması aşamasında ve ameliyat sonrası yoğun bakım kalış süresi 0, 6, 12. ve 24. saatlerdeki arteriyel kan gazı analizleri kaydedildi. Hastalar laktat düzeylerine göre iki gruba ayrıldı: (Grup 1 laktat düzeyi <4.5 mmol/L, n=183; Grup 2 laktat düzeyi ≥4.5 mmol/L, n=53). Gruplar ile hastaların demografik verileri, ameliyat sırası ve ameliyat sonrası değişkenler, komplikasyonlar ve mortalite arasındaki ilişki araştırıldı. Bul gu lar:Altmış dokuz hastada (%29.2) siyanotik kalp hastalığı vardı. Toplamda 53 hastada (%22.5) laktat düzeyi 4.5 mmol/L ve üzerinde idi. Hastaların %41'inde en az bir komplikasyon gelişti. Laktat düzeyi ≥4.5 mmol/L grupta en az bir komplikasyon gelişimi (p= 0.027) ve mortalite oranı (p<0.001) anlamlı olarak daha yüksekti. On yedi hasta (%7.2) ameliyat sonrası dönemde kaybedildi ve bu hastaların 15'inde laktat düzeyi ilk 24 saatte en az bir kez ≥4.5 mmol/L idi. Herhangi bir dönemde laktat düzeylerinin ≥4.5 mmol/L olması, uzamış mekanik ventilasyon (>48 saat) ve hastanın kompleks cerrahi geçirmesi (yüksek Risk-adjusted Classification for Congenital Heart Surgery-1 skoru, kategori 4-6) mortalite için bağımsız risk faktörü olarak tespit edildi.So nuç:Doğuştan kalp cerrahisi uygulanan çocuk hastalarda, arteriyel laktat düzeyinin 4.5 mmol/L veya üzerinde olmasının ameliyat sonrası morbidite ve mortalite için bağımsız risk faktörü olduğu saptandı.Anah tarsöz cük ler: Kardiyak cerrahi; doğuştan; kalp kusurları; laktat; ölüm oranı; ameliyat sonrası komplikasyonlar ABSTRACT Background: This study aimed to investigate the correlation between perioperative arterial lactate levels and morbidity and mortality in children undergoing cardiac surgery.

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“…Criticality and clinical course were established based on AMV requirement, mean airway pressure (MAP), FIO 2 , oxygenation index (OI), inotrope use, vasoactive-inotropic score (VIS) 22 (dose: dopamine + dobutamine + 100 x epinephrine + 10 x milrinone + 10 000 x vasopressin + 100 x norepinephrine), inhaled nitric oxide (iNO) use, extracorporeal membrane oxygenation (ECMO) requirement, impairment of liver and/or kidney function, multiple organ dysfunction syndrome (MODS), and death.…”

Section: Methodsmentioning

confidence: 99%

B-type natriuretic peptide: Usefulness in the management of critically-ill neonates

et al. 2017

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B-type natriuretic peptide (BNP) is responsible for changes in the heart organogenesis and is associated with transition to extrauterine life. In the first week of life, BNP levels are high and return to normal with the physiological loss in weight. High BNP levels are associated with different conditions. Objective. To establish the relationship between BNP levels and criticality and the short-term clinical course among patients hospitalized in the neonatal intensive care unit. Method. Observational and analytical study conducted in a prospective cohort. Criticality was defined as a requirement for assisted mechanical ventilation with a fraction of inspired oxygen of more than 50% and/or inotropes. Two blood samples were collected 72 hours apart. Results. Seventy-three patients were included in the study. Depending on their clinical course on day 7, they were divided into 2 groups: patients with a good clinical course or a persistent, severe clinical course. The median baseline BNP level was similar in both groups (p: 0.15). The median BNP level at 72 hours was higher among patients with a persistent, severe clinical course (p: 0.005). The difference between both BNP values was calculated (∆BNP: BNP level at 72 hours -BNP level at 0 hours). The ∆BNP was positive among patients with a persistent, severe clinical course (X= 1260 pg/mL; range: 426-2094) and negative in the group with a good clinical course (X= -967 pg/mL; range: -1656/-278) (p: 0.0002); sensitivity: 87%; specificity: 86%; positive predictive value: 74%; and negative predictive value: 93%. Conclusion. In this group of patients, the delta-BNP value reflected the short-term clinical course.

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Vasoactive Inotropic Score (Vis) Is Associated With Outcome After Infant Cardiac Surgery: A Report of the Pediatric Cardiac Critical Care Consortium (Pc4)

Cited by 116 publications

References 0 publications

Extubation Failure after Neonatal Cardiac Surgery: A Multicenter Analysis

Extubation Failure after Neonatal Cardiac Surgery: A Multicenter Analysis

Correlation between serum lactate levels and outcome in pediatric patients undergoing congenital heart surgery

B-type natriuretic peptide: Usefulness in the management of critically-ill neonates

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