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Correlation Between Pediatric Open Heart Surgery Outcomes and Arterial-mixed Venous Oxygen Saturation Differences
Mahmood Samadi1, Majid Malaki, Shamsi Ghaffari
1Department of Pediatric Cardiology, Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Insights
Arterial-mixed venous oxygen saturation difference is not a reliable predictor of outcomes after pediatric cardiac surgery. While differences are higher in complicated cases up to 18 hours, they do not predict ventilation duration.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Surgery
- Critical Care Medicine
Background:
- Low Cardiac Output Syndrome (LCOS) is a significant cause of morbidity and mortality following cardiac operations.
- Identifying predictive factors for postoperative outcomes is crucial for improving patient care.
Purpose of the Study:
- To evaluate the arterial-mixed venous oxygen saturation difference as a potential predictor of outcomes in children undergoing cardiovascular surgery.
- To determine if this measure can predict complications or the need for prolonged support.
Main Methods:
- A cross-sectional study involving 100 children with congenital heart disease undergoing surgery with cardiopulmonary bypass.
- Arterial and central venous oxygen saturation were measured at 6-hour intervals for 24 hours postoperatively.
- Statistical analysis compared oxygen saturation differences with postoperative ventilation and cardiovascular support durations.
Main Results:
- Mortality was 6% and complications occurred in 45% of patients.
- The highest arterial-mixed venous oxygen saturation difference was observed immediately post-operation (up to 57%).
- While differences were higher in complicated vs. non-complicated groups up to 18 hours, this measure did not predict prolonged intubation periods.
Conclusions:
- The arterial-mixed venous oxygen saturation difference, though elevated in complicated cases, is not a discriminative predictor of outcomes after pediatric cardiac surgery.
- Higher differences may indicate tissue ischemia but do not reliably forecast the need for extended ventilation or cardiovascular support.
Introduction:
Low Cardiac Output Syndrome (LCOS) contributes to postoperative morbidity and mortality. This article tries to find a predictive factor to interpret outcome after cardiac operation.
Methods:
In a cross-sectional study, 100 children with congenital heart disease undergoing cardiovascular surgery with cardiopulmonary bypass (CPB) without significant left-to-right shunt were selected. Arterial and central venous oxygen saturation values were measured via blood samples simultaneously obtained in 6-hr intervals for a total of 24-hr during postoperative period at hours 0, 6, 12, 18, and 24. Postoperative ventilation support (intubation period) and cardiovascular support were also obtained from the hospital records. Statistical analysis was later performed comparing the arterial-mixed venous oxygen saturation differences and durations of required ventilatory and cardiovascular support, both for the complicated and non-complicated patient groups. The data was processed with correlation Pearson and Mann-Whitney U tests in SPSS 15 software, P less than 0.05 was significant.
Results:
Mortality following cardiac operation is 6% and complications may happen in 45% of the cases. The highest Arterial-mixed venous oxygen saturation difference occurred immediately post operation (up to 57%). These measures were high up to 18 hours in complicated and non-complicated groups (36% vs. 31% ; P< 0.05). This factor cannot predict prolongation of intubation period in patients (P > 0.05).
Conclusion:
Arterial-mixed venous oxygen saturation difference may be high as much as 57% or as low as 23%.These different measures, being higher up to 18 hours in complicated to non-complicated groups after 18 hours, can be related to tissue ischemia during surgery and cannot be discriminative.
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