[Low cardiac output syndrome score to evaluate postoperative cardiac surgery patients in a pediatric intensive care unit]

Turk Kardiyol Dern Ars. 2020 Jul;48(5):504-513. doi: 10.5543/tkda.2020.13844.
[Article in Turkish]

Abstract

Objective: There is no clear consensus regarding the definition of low cardiac output syndrome (LCOS) or the follow-up of this patient group. Given this lack of a clinical definition, the aim of this study was to use a LCOS score (LCOSs) similar to the low cardiac output score previously presented in the literature and evaluate the relationship between a high LCOSs and poor clinical outcome.

Methods: A total of 54 patients were prospectively evaluated after cardiac surgery. The LCOSs was used to evaluate the deve-lopment of low cardiac output. Each parameter was scored as 1 point. The score was calculated every hour for 24 hours postoperatively and the highest score was recorded as the peak score (pLOCSs). The LOCSs at the time of admission to the pediatric intensive care unit, at the 4th, 8th, and 16th hour were recorded and a cumulative score (cLOCSs) score was calculated.

Results: The mean age of the patients was 49.40±53.15 months and 24.07% had LOCS. In the group with LCOS, the cLOCSs, vasoactive-ınotropic score (VIS), lactate mean, aortic clamp time, and the total cardiopulmonary bypass time were significantly higher. In this study, a significant and positive correlation was found between the cLOCSs and pLOCSs and the length of hospital stay, length of stay in the pediatric intensive care unit, VIS, lactate mean, and aortic clamp duration.

Conclusion: The objective of this study was to draw attention to the potential use of a common language in the care of critical pediatric patients undergoing cardiac surgery with a previously defined scoring method that includes parameters indicating poor perfusion in the patient.

MeSH terms

  • Aorta
  • Cardiac Output, Low / blood
  • Cardiac Output, Low / diagnosis*
  • Cardiac Output, Low / etiology
  • Cardiac Surgical Procedures / adverse effects*
  • Cardiopulmonary Bypass / statistics & numerical data
  • Child, Preschool
  • Constriction
  • Female
  • Humans
  • Intensive Care Units, Pediatric
  • Lactic Acid / blood
  • Male
  • Operative Time
  • Postoperative Complications / diagnosis*
  • Postoperative Complications / etiology
  • Prospective Studies
  • Time Factors

Substances

  • Lactic Acid