Clinical and Laboratory Predictors for the Development of Low Cardiac Output Syndrome in Infants Undergoing Cardiopulmonary Bypass: A Pilot Study.
Clinical and Laboratory Predictors for the Development of Low Cardiac Output Syndrome in Infants Undergoing Cardiopulmonary Bypass: A Pilot Study.
复制标题
DOI：
10.3390/jcm10040712
复制
发表时间：
2021-02-11
影响因子：
3.9
通讯作者：
Chaaban H
中科院分区：
文献类型：
--
作者：
Drennan SE;Burge KY;Szyld EG;Eckert JV;Mir AM;Gormley AK;Schwartz RM;Daves SM;Thompson JL;Burkhart HM;Chaaban H
使用体外循环的心脏手术使婴儿面临发病率和死亡率的高风险。这项研究的目的是评估临床和实验室变量在预测婴儿心脏手术后常见并发症--低心输出量综合征发展的有效性。我们在一家学术儿童医院的儿科心血管ICU进行了一项前瞻性观察研究。纳入31例先天性心脏病患者。在围手术期的6个时间点检测血清核小体和一组20种细胞因子的水平。与非体外循环患者相比，体外循环患者入院时白细胞介素10、-6和-1α水平升高是其特征。与未发生低心排血量综合征的患者相比，发生低心排血量综合征的患者在术后12小时耐受主动脉阻断时间更长，需要更多的肌力支持。术前、术后24小时IL-10水平升高与低心输出量综合征相关。受试者工作特征曲线分析显示，主动脉阻断时间对低心输出量综合征的预测能力中等，但不能预测IL-8。总之，在我们的患者群体中，通过主动脉阻断时间的外科测量来预测低心输出量综合征是最好的。
Cardiac surgery employing cardiopulmonary bypass exposes infants to a high risk of morbidity and mortality. The objective of this study was to assess the utility of clinical and laboratory variables to predict the development of low cardiac output syndrome, a frequent complication following cardiac surgery in infants. We performed a prospective observational study in the pediatric cardiovascular ICU in an academic children’s hospital. Thirty-one patients with congenital heart disease were included. Serum levels of nucleosomes and a panel of 20 cytokines were measured at six time points in the perioperative period. Cardiopulmonary bypass patients were characterized by increased levels of interleukin-10, -6, and -1α upon admission to the ICU compared to non-bypass cardiac patients. Patients developing low cardiac output syndrome endured longer aortic cross-clamp time and required greater inotropic support at 12 h postoperatively compared to bypass patients not developing the condition. Higher preoperative interleukin-10 levels and 24 h postoperative interleukin-8 levels were associated with low cardiac output syndrome. Receiver operating characteristic curve analysis demonstrated a moderate capability of aortic cross-clamp duration to predict low cardiac output syndrome but not IL-8. In conclusion, low cardiac output syndrome was best predicted in our patient population by the surgical metric of aortic cross-clamp duration.
登录
查看更多内容
心脏手术患者无细胞DNA水平的围手术期升高：中性粒细胞外陷阱对围手术期肾功能障碍的可能贡献。
影响因子：
1.4
作者：
Qi Y;Uchida T;Yamamoto M;Yamamoto Y;Kido K;Ito H;Ohno N;Asahara M;Yamada Y;Yamaguchi O;Mitaka C;Tomita M;Makita K
通讯作者：
Makita K
影响因子：
4.1
作者：
Gaies, Michael G.;Gurney, James G.;Hirsch, Jennifer C.
通讯作者：
Hirsch, Jennifer C.
影响因子：
6.7
作者：
Longstaff, Colin;Hogwood, John;Kolev, Krasimir
通讯作者：
Kolev, Krasimir
影响因子：
6
作者：
Hövels-Gürich, HH;Vazquez-Jimenez, JF;Seghaye, MC
通讯作者：
Seghaye, MC
影响因子：
4.8
作者：
Kalbitz, Miriam;Grailer, Jamison J.;Ward, Peter A.
通讯作者：
Ward, Peter A.