Central Venous Oxygen Saturation/Lactate Ratio and Prediction of Major Adverse Events After Pediatric Heart Surgery
Autor(a) principal: | |
---|---|
Data de Publicação: | 2021 |
Outros Autores: | , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Brazilian Journal of Cardiovascular Surgery (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382021000600736 |
Resumo: | Abstract Introduction: Major adverse events (MAE) are unexpected but undesirably frequent after pediatric congenital heart surgery and contribute to poorer outcomes. The aim of this study was to test the predictive value of a ratio between central venous oxygen saturation and arterial lactate (ScvO2/lactate) for MAE after pediatric congenital heart surgery in a Brazilian university hospital. Methods: We conducted a retrospective observational study in a tertiary care university hospital, including 194 infants and children submitted to surgery for congenital heart disease. The predictive value of ScvO2, lactate, and ScvO2/lactate ratio were assessed by the area under the receiver operating characteristics curve (AUC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Results: The incidence of MAE was 16% — cardiac arrest/death, unplanned reoperation, and low cardiac output syndrome were the most common events. Overall, ScvO2/lactate ratio discriminated patients with and without MAE very well (AUC 0.842), performing better than either variable alone, with sensitivity of 48%, specificity of 94%, PPV of 60%, and NPV of 91%. Conclusion: A ScvO2/lactate ratio > 5 can accurately identify patients at low risk of MAE after pediatric congenital heart surgery, with very good specificity and NPV, but poor sensitivity and PPV. |
id |
SBCCV-1_474e8d0f3f308e55798b480264474304 |
---|---|
oai_identifier_str |
oai:scielo:S0102-76382021000600736 |
network_acronym_str |
SBCCV-1 |
network_name_str |
Brazilian Journal of Cardiovascular Surgery (Online) |
repository_id_str |
|
spelling |
Central Venous Oxygen Saturation/Lactate Ratio and Prediction of Major Adverse Events After Pediatric Heart SurgeryCongenital Heart DiseaseCardiac SurgeryPulmonary Gas ExchangeSensitivity and SpecificityHeart ArrestIncidenceAbstract Introduction: Major adverse events (MAE) are unexpected but undesirably frequent after pediatric congenital heart surgery and contribute to poorer outcomes. The aim of this study was to test the predictive value of a ratio between central venous oxygen saturation and arterial lactate (ScvO2/lactate) for MAE after pediatric congenital heart surgery in a Brazilian university hospital. Methods: We conducted a retrospective observational study in a tertiary care university hospital, including 194 infants and children submitted to surgery for congenital heart disease. The predictive value of ScvO2, lactate, and ScvO2/lactate ratio were assessed by the area under the receiver operating characteristics curve (AUC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Results: The incidence of MAE was 16% — cardiac arrest/death, unplanned reoperation, and low cardiac output syndrome were the most common events. Overall, ScvO2/lactate ratio discriminated patients with and without MAE very well (AUC 0.842), performing better than either variable alone, with sensitivity of 48%, specificity of 94%, PPV of 60%, and NPV of 91%. Conclusion: A ScvO2/lactate ratio > 5 can accurately identify patients at low risk of MAE after pediatric congenital heart surgery, with very good specificity and NPV, but poor sensitivity and PPV.Sociedade Brasileira de Cirurgia Cardiovascular2021-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382021000600736Brazilian Journal of Cardiovascular Surgery v.36 n.6 2021reponame:Brazilian Journal of Cardiovascular Surgery (Online)instname:Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV)instacron:SBCCV10.21470/1678-9741-2020-0521info:eu-repo/semantics/openAccessRocha,Victória Helena StelzerManso,Paulo HenriqueCarmona,Fabioeng2021-12-02T00:00:00Zoai:scielo:S0102-76382021000600736Revistahttp://www.rbccv.org.br/https://old.scielo.br/oai/scielo-oai.php||rosangela.monteiro@incor.usp.br|| domingo@braile.com.br|| brandau@braile.com.br1678-97410102-7638opendoar:2021-12-02T00:00Brazilian Journal of Cardiovascular Surgery (Online) - Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV)false |
dc.title.none.fl_str_mv |
Central Venous Oxygen Saturation/Lactate Ratio and Prediction of Major Adverse Events After Pediatric Heart Surgery |
title |
Central Venous Oxygen Saturation/Lactate Ratio and Prediction of Major Adverse Events After Pediatric Heart Surgery |
spellingShingle |
Central Venous Oxygen Saturation/Lactate Ratio and Prediction of Major Adverse Events After Pediatric Heart Surgery Rocha,Victória Helena Stelzer Congenital Heart Disease Cardiac Surgery Pulmonary Gas Exchange Sensitivity and Specificity Heart Arrest Incidence |
title_short |
Central Venous Oxygen Saturation/Lactate Ratio and Prediction of Major Adverse Events After Pediatric Heart Surgery |
title_full |
Central Venous Oxygen Saturation/Lactate Ratio and Prediction of Major Adverse Events After Pediatric Heart Surgery |
title_fullStr |
Central Venous Oxygen Saturation/Lactate Ratio and Prediction of Major Adverse Events After Pediatric Heart Surgery |
title_full_unstemmed |
Central Venous Oxygen Saturation/Lactate Ratio and Prediction of Major Adverse Events After Pediatric Heart Surgery |
title_sort |
Central Venous Oxygen Saturation/Lactate Ratio and Prediction of Major Adverse Events After Pediatric Heart Surgery |
author |
Rocha,Victória Helena Stelzer |
author_facet |
Rocha,Victória Helena Stelzer Manso,Paulo Henrique Carmona,Fabio |
author_role |
author |
author2 |
Manso,Paulo Henrique Carmona,Fabio |
author2_role |
author author |
dc.contributor.author.fl_str_mv |
Rocha,Victória Helena Stelzer Manso,Paulo Henrique Carmona,Fabio |
dc.subject.por.fl_str_mv |
Congenital Heart Disease Cardiac Surgery Pulmonary Gas Exchange Sensitivity and Specificity Heart Arrest Incidence |
topic |
Congenital Heart Disease Cardiac Surgery Pulmonary Gas Exchange Sensitivity and Specificity Heart Arrest Incidence |
description |
Abstract Introduction: Major adverse events (MAE) are unexpected but undesirably frequent after pediatric congenital heart surgery and contribute to poorer outcomes. The aim of this study was to test the predictive value of a ratio between central venous oxygen saturation and arterial lactate (ScvO2/lactate) for MAE after pediatric congenital heart surgery in a Brazilian university hospital. Methods: We conducted a retrospective observational study in a tertiary care university hospital, including 194 infants and children submitted to surgery for congenital heart disease. The predictive value of ScvO2, lactate, and ScvO2/lactate ratio were assessed by the area under the receiver operating characteristics curve (AUC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Results: The incidence of MAE was 16% — cardiac arrest/death, unplanned reoperation, and low cardiac output syndrome were the most common events. Overall, ScvO2/lactate ratio discriminated patients with and without MAE very well (AUC 0.842), performing better than either variable alone, with sensitivity of 48%, specificity of 94%, PPV of 60%, and NPV of 91%. Conclusion: A ScvO2/lactate ratio > 5 can accurately identify patients at low risk of MAE after pediatric congenital heart surgery, with very good specificity and NPV, but poor sensitivity and PPV. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-12-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382021000600736 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382021000600736 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.21470/1678-9741-2020-0521 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Cirurgia Cardiovascular |
publisher.none.fl_str_mv |
Sociedade Brasileira de Cirurgia Cardiovascular |
dc.source.none.fl_str_mv |
Brazilian Journal of Cardiovascular Surgery v.36 n.6 2021 reponame:Brazilian Journal of Cardiovascular Surgery (Online) instname:Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV) instacron:SBCCV |
instname_str |
Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV) |
instacron_str |
SBCCV |
institution |
SBCCV |
reponame_str |
Brazilian Journal of Cardiovascular Surgery (Online) |
collection |
Brazilian Journal of Cardiovascular Surgery (Online) |
repository.name.fl_str_mv |
Brazilian Journal of Cardiovascular Surgery (Online) - Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV) |
repository.mail.fl_str_mv |
||rosangela.monteiro@incor.usp.br|| domingo@braile.com.br|| brandau@braile.com.br |
_version_ |
1752126602597105664 |