Comparison of maximum vasoactive inotropic score and low cardiac output syndrome as markers of early postoperative outcomes after neonatal cardiac surgery

Ryan J. Butts, Mark A. Scheurer, Andrew M. Atz, Sinai C. Zyblewski, Thomas C. Hulsey, Scott M. Bradley, Eric M. Graham

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Low cardiac output syndrome (LCOS) and maximum vasoactive inotropic score (VIS) have been used as surrogate markers for early postoperative outcomes in pediatric cardiac surgery. The objective of this study was to determine the associations between LCOS and maximum VIS with clinical outcomes in neonatal cardiac surgery. This was a secondary retrospective analysis of a prospective randomized trial, and the setting was a pediatric cardiac intensive care unit in a tertiary care children's hospital. Neonates (n = 76) undergoing corrective or palliative cardiac operations requiring cardiopulmonary bypass were prospectively enrolled. LCOS was defined by a standardized clinical criteria. VIS values were calculated by a standard formula during the first 36 postoperative hours, and the maximum score was recorded. Postoperative outcomes included hospital mortality, duration of mechanical ventilation, intensive care unit (ICU) and hospital lengths of stay (LOS), as well as total hospital charges. At surgery, the median age was 7 days and weight was 3.2 kg. LCOS occurred in 32 of 76 (42%) subjects. Median maximum VIS was 15 (range 5-33). LCOS was not associated with duration of mechanical ventilation, ICU LOS, hospital LOS, and hospital charges. Greater VIS was moderately associated with a longer duration of mechanical ventilation (p = 0.001, r = 0.36), longer ICU LOS (p = 0.02, r = 0.27), and greater total hospital costs (p = 0.05, r = 0.22) but not hospital LOS (p = 0.52). LCOS was not associated with early postoperative outcomes. Maximum VIS has only modest correlation with duration of mechanical ventilation, ICU LOS, and total hospital charges.

Original languageEnglish (US)
Pages (from-to)633-638
Number of pages6
JournalPediatric Cardiology
Volume33
Issue number4
DOIs
StatePublished - Apr 1 2012

Fingerprint

Low Cardiac Output
Thoracic Surgery
Length of Stay
Hospital Charges
Artificial Respiration
Intensive Care Units
Pediatric Intensive Care Units
Hospital Costs
Tertiary Healthcare
Hospital Mortality
Cardiopulmonary Bypass
Biomarkers
Newborn Infant
Pediatrics
Weights and Measures

Keywords

  • Cardiac surgery
  • Cardiopulmonary bypass
  • Low cardiac output syndrome
  • Neonates
  • Postoperative outcomes
  • Vasoactive inotropic score

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pediatrics, Perinatology, and Child Health

Cite this

Comparison of maximum vasoactive inotropic score and low cardiac output syndrome as markers of early postoperative outcomes after neonatal cardiac surgery. / Butts, Ryan J.; Scheurer, Mark A.; Atz, Andrew M.; Zyblewski, Sinai C.; Hulsey, Thomas C.; Bradley, Scott M.; Graham, Eric M.

In: Pediatric Cardiology, Vol. 33, No. 4, 01.04.2012, p. 633-638.

Research output: Contribution to journalArticle

Butts, Ryan J. ; Scheurer, Mark A. ; Atz, Andrew M. ; Zyblewski, Sinai C. ; Hulsey, Thomas C. ; Bradley, Scott M. ; Graham, Eric M. / Comparison of maximum vasoactive inotropic score and low cardiac output syndrome as markers of early postoperative outcomes after neonatal cardiac surgery. In: Pediatric Cardiology. 2012 ; Vol. 33, No. 4. pp. 633-638.
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