Clinical parameters to predict adverse outcomes in patients with shunt-dependent physiology with a Blalock-Taussig-Thomas shunt.

IF 0.9 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Annals of Pediatric Cardiology Pub Date : 2023-09-01 Epub Date: 2024-04-01 DOI:10.4103/apc.apc_135_23
Saloni P Shah, Rohit S Loomba
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Abstract

In patients with shunt-dependent physiology, early risk factor identification can facilitate the prevention of adverse outcomes. This study aims to determine a scoring system to estimate the risk for adverse outcomes after Blalock-Taussig-Thomas shunt placement. Of the 39 neonates with Blalock-Taussig-Thomas shunt placement, 10 experienced the composite outcome. The resulting risk score from clinical and hemodynamic variables attributed 1 point for each of the following: central venous pressure >7.8, serum lactate >1.8 mmol/L, renal oxygen extraction ratio >32, and vasoactive-inotrope score >8.7. A score of 0 was associated with a 0% risk of the composite outcome, a score of 1 or 2 with a 15% risk, and a score of 3 or 4 with a 60% risk. A combination of increased central venous pressure, increased serum lactate, increased renal oxygen extraction ratio, and increased vasoactive-inotrope score are highly accurately associated with the risk of cardiopulmonary arrest, need for extracorporeal membrane oxygenation, or inpatient mortality after a Blalock-Taussig-Thomas shunt in patients with shunt-dependent physiology.

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预测布洛克-陶西格-托马斯分流术分流依赖生理患者不良后果的临床参数。
对于具有分流依赖性生理学的患者,早期识别风险因素有助于预防不良后果的发生。本研究旨在确定一个评分系统,以估计布洛克-陶西格-托马斯分流术后不良后果的风险。在 39 名接受布洛克-陶西格-托马斯分流术的新生儿中,有 10 名出现了综合结果。根据临床和血液动力学变量得出的风险评分为:中心静脉压>7.8、血清乳酸>1.8 mmol/L、肾氧萃取比>32、血管活性-肌动素评分>8.7,每项均得 1 分。评分为 0 时,出现综合结果的风险为 0%;评分为 1 或 2 时,风险为 15%;评分为 3 或 4 时,风险为 60%。中心静脉压升高、血清乳酸升高、肾氧萃取率升高和血管活性肌醇评分升高的组合与分流依赖性生理学患者在布洛克-陶西格-托马斯分流术后发生心肺骤停、需要体外膜氧合或住院死亡率的风险高度精确相关。
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来源期刊
Annals of Pediatric Cardiology
Annals of Pediatric Cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
1.40
自引率
14.30%
发文量
51
审稿时长
23 weeks
期刊最新文献
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