Clinical and laboratory predictors for the development of low cardiac output syndrome in infants undergoing cardiopulmonary bypass: A pilot study

Sarah E. Drennan, Kathryn Y. Burge, Edgardo G. Szyld, Jeffrey V. Eckert, Arshid M. Mir, Andrew K. Gormley, Randall M. Schwartz, Suanne M. Daves, Jess L. Thompson, Harold M. Burkhart, Hala Chaaban

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1 Scopus citations

Abstract

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 meas-ured at six time points in the perioperative period. Cardiopulmonary bypass patients were charac-terized 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 aor-tic 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 op-erating 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.

Original languageEnglish (US)
Article number712
Pages (from-to)1-17
Number of pages17
JournalJournal of Clinical Medicine
Volume10
Issue number4
DOIs
StatePublished - Feb 2 2021

Keywords

  • Cardiopulmonary bypass
  • Congenital heart disease
  • Inflammation
  • Low cardiac output syndrome
  • Pediatric cardiology

ASJC Scopus subject areas

  • Medicine(all)

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