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Central venous oxygen saturation/lactate ratio and prediction of major adverse events after pediatric heart surgery
Rocha, Victória Helena Stelzer; Manso, Paulo Henrique; Carmona, Fabio.
  • Rocha, Victória Helena Stelzer; Universidade de São Paulo. Department of Pediatrics. Faculdade de Medicina de Ribeirão Preto. Ribeirão Preto. BR
  • Manso, Paulo Henrique; Universidade de São Paulo. Department of Pediatrics. Faculdade de Medicina de Ribeirão Preto. Ribeirão Preto. BR
  • Carmona, Fabio; Universidade de São Paulo. Department of Pediatrics. Faculdade de Medicina de Ribeirão Preto. Ribeirão Preto. BR
Rev. bras. cir. cardiovasc ; 36(6): 736-742, Nov.-Dec. 2021. tab, graf
Article in English | LILACS | ID: biblio-1351672
ABSTRACT
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.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Heart Defects, Congenital / Cardiac Surgical Procedures Type of study: Observational study / Prognostic study / Risk factors Limits: Child / Humans / Infant Language: English Journal: Rev. bras. cir. cardiovasc Journal subject: Cardiology / General Surgery Year: 2021 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade de São Paulo/BR

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Full text: Available Index: LILACS (Americas) Main subject: Heart Defects, Congenital / Cardiac Surgical Procedures Type of study: Observational study / Prognostic study / Risk factors Limits: Child / Humans / Infant Language: English Journal: Rev. bras. cir. cardiovasc Journal subject: Cardiology / General Surgery Year: 2021 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade de São Paulo/BR