PMID: 9434699Jan 22, 1998Paper

Early markers of major adverse events in children after cardiac operations

The Journal of Thoracic and Cardiovascular Surgery
Trevor DukeT R Karl

Abstract

The purpose of this study was to determine the physiologic variables that predict major adverse events in children in the intensive care unit after cardiac operations. A cohort observational study was conducted. At the time of admission to the intensive care unit and 4, 8, 12, and 24 hours later the following variables were recorded: mean arterial pressure, heart rate, cardiac index, oxygen delivery, mixed venous oxygen saturation, base deficit, blood lactate, gastric intramucosal pH, carbon dioxide difference (the difference between arterial carbon dioxide tension and gastric intraluminal carbon dioxide tension), and toe-core temperature gradient. Major adverse events were prospectively identified as cardiac arrest, need for emergency chest opening, development of multiple organ failure, and death. Ninety children were included in the study; 12 had major adverse events and there were 4 deaths. Blood lactate level, mean arterial pressure, and duration of cardiopulmonary bypass were the only significant, independent predictors of major adverse events when measured at the time of admission to the intensive care unit. The odds ratio (95% confidence intervals) for major adverse events if a lactate level was greater than 4.5 mmol/L ...Continue Reading

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Citations

Mar 23, 2007·Intensive Care Medicine·Mark HatherillAndrew Argent
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May 1, 2008·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Meena KalyanaramanTimothy S Yeh
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