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Cardiac Arrest With or Without Need for Extracorporeal Life Support After Congenital Cardiac Surgery

Nicole Bencie1, Fabio Savorgnan2, Ziyad Binsalamah3

  • 1Warren Alpert Medical School of Brown University, Providence, Rhode Island; Arthur S. Keats Division of Pediatric Cardiovascular Anesthesia, Department of Anesthesiology, Perioperative and Pain Medicine, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas.

The Annals of Thoracic Surgery
|September 13, 2023
PubMed

Insights

Postoperative cardiac arrest (CA) after pediatric heart surgery is a serious complication. A new predictive model, incorporating preoperative risk factors and intraoperative data, can identify patients at higher risk for CA with or without extracorporeal cardiopulmonary resuscitation (ECPR).

Area of Science:

  • Pediatric cardiac surgery
  • Cardiovascular research
  • Predictive modeling in medicine

Background:

  • Postoperative cardiac arrest (CA) and the need for extracorporeal cardiopulmonary resuscitation (ECPR) are significant complications following pediatric cardiac operations.
  • Developing a reliable predictive model for these events is crucial for improving patient outcomes.

Approach:

  • This retrospective cohort study analyzed data from pediatric patients who underwent cardiac surgery with cardiopulmonary bypass (CPB) between July 2020 and December 2021.
  • Multivariable logistic regression was employed to identify predictors and develop a predictive model for postoperative CA with or without ECPR.

Key Points:

  • The incidence of CA with or without ECPR was 4.4%.
  • Key predictors identified include the presence of at least one preoperative risk factor, longer CPB duration, higher intraoperative residual lesion score (RLS), and higher postsurgery vasoactive-inotropic score (VIS).
  • Patients experiencing CA were younger and required longer CPB and cross-clamp times.

Conclusions:

  • A validated predictive model for postoperative CA with or without ECPR in pediatric cardiac surgery patients has been developed.
  • This model demonstrates superior performance compared to individual risk factors or scores, offering a promising tool for risk stratification.
Abstract

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