We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Adverse events in the postoperative period of cardiac surgery in a pediatric intensive care unit: the contribution of the VIS score and the RACHS-1.
- Authors
Ramos Wasniewski, Ana Beatriz; Pires Ricachinevsky, Claudia; Queiroz Rezende, Raíssa; Tomasi Lorentz, Bruna; da Silva Silveira, Edinara; Rampon Angeli, Viviane Helena; González de Oliveira, Mariana; Reverbel da Silveira, Themis
- Abstract
Objective: To evaluate the occurrence of adverse events in the postoperative period of cardiac surgery in a pediatric intensive care unit and to find any patient characteristics that can predict such events. Methods: This was a historical cohort study of patients recovering in the pediatric intensive care unit for the first 7 days after cardiac surgery between April and December 2019, by reviewing the medical records. The following were reviewed: demographic, clinical, and laboratory characteristics; patient severity scores; and selected adverse events, grouped into device-related, surgical, and nonsurgical. Results: A total of 238 medical records were included. At least one adverse event occurred in 110 postoperative patients (46.2%). The total number of adverse events was 193 (81%). Vascular catheters were the most common cause, followed by cardiac arrest, bleeding, and surgical reexploration. In the univariate analysis, the vasoactive-inotropic score (VIS), Risk Adjustment in Congenital Heart Surgery (RACHS-1) score, age, Pediatric Index of Mortality (PIM-2), cardiopulmonary bypass and aortic clamping duration were significantly associated with adverse events. In the multivariate analysis, VIS = 20 (OR 2.90; p = 0.004) and RACHS-1 = 3 (OR 2.11; p = 0.019) were significant predictors, while age and delayed sternal closure showed only trends toward significance. To predict the occurrence of adverse events from VIS and RACHS-1, the area under the curve was 0.73 (95%CI 0.66 - 0.79). Conclusion: Adverse events were quite frequent in children after cardiac surgery, especially those related to devices. The VIS and RACHS-1, used together, predicted the occurrence of adverse events well in this pediatric sample.
- Subjects
CARDIAC surgery; POSTOPERATIVE care; INTENSIVE care units; CARDIAC arrest; MULTIVARIATE analysis
- Publication
Critical Care Science, 2023, Vol 35, Issue 4, p377
- ISSN
2965-2774
- Publication type
Article
- DOI
10.5935/2965-2774.20230215-en