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Related Concept Videos

  1. Home
  3. Prediction Of Vasoactive-inotropic Score On Prolonged Mechanical Ventilation In Adult Congenital Heart Disease Patients After Surgical Treatment Combined With Coronary Artery Bypass Grafting.
  1. Home
  3. Prediction Of Vasoactive-inotropic Score On Prolonged Mechanical Ventilation In Adult Congenital Heart Disease Patients After Surgical Treatment Combined With Coronary Artery Bypass Grafting.

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Prediction of Vasoactive-Inotropic Score on Prolonged Mechanical Ventilation in Adult Congenital Heart Disease

Jia Liu1, Yinghong Zhang1, Wen Zhang2

  • 1Institute of Nursing Research, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Medicine, Wuhan University of Science and Technology, Wuhan, People's Republic of China.

Brazilian Journal of Cardiovascular Surgery
|May 15, 2024

View abstract on PubMed

Summary
This summary is machine-generated.
Keywords:
AdultCongenital Heart DiseaseCoronary Artery BypassMechanical VentilationVasoactive-inotropic score

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The vasoactive-inotropic score (VIS) measured at the end of surgery effectively predicts prolonged mechanical ventilation (PMV) in adult congenital heart disease patients. This score is a crucial independent risk factor for PMV post-surgery.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Critical Care Medicine

Background:

  • Adult congenital heart disease (ACHD) patients undergoing complex surgeries face risks.
  • Prolonged mechanical ventilation (PMV) is a significant postoperative complication.
  • Predictive tools are needed to identify patients at high risk for PMV.

Purpose of the Study:

  • To evaluate the predictive value of the vasoactive-inotropic score (VIS) at various postoperative time points for PMV.
  • To determine if VIS is an independent predictor of PMV in ACHD patients undergoing combined surgical treatment and coronary artery bypass grafting (CABG).

Main Methods:

  • Retrospective analysis of 250 ACHD patients undergoing surgery with CABG.
  • Patients were grouped based on the development of PMV.
  • Propensity score matching was used to balance confounding factors.
  • Receiver operating characteristic (ROC) curves analyzed VIS predictive accuracy.
  • Multivariate logistic regression identified independent risk factors.

    • Main Results:

    • The PMV rate was 20.8% (52/250 patients).
    • VIS at all measured time points predicted PMV (Area Under Curve > 0.500).
    • VIS at the end of surgery showed the highest predictive value (AUC=0.805).
    • An optimal VIS cutoff of 6.5 predicted PMV with 78.7% sensitivity and 72.3% specificity.
    • VIS at the end of surgery was an independent risk factor for PMV (OR=1.301, P<0.01).

    Conclusions:

    • The vasoactive-inotropic score (VIS) measured at the end of surgery is a valuable predictor of PMV.
    • VIS is an independent risk factor for PMV in ACHD patients after combined surgery.
    • Early identification of PMV risk using VIS can inform clinical management.