For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
1
views
27
references
 Top references
cited by
1
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      503
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Inotropic score and vasoactive inotropic score as predictors of outcomes in congenital diaphragmatic hernia: A single center retrospective study

      research-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Neonates with congenital diaphragmatic hernia (CDH) have varying degrees of pulmonary hypoplasia, pulmonary hypertension (PH) and cardiac dysfunction. These neonates frequently require vasoactive support and are at high risk for mortality and morbidity, including prolonged ventilator support, need for extracorporeal membrane oxygenation (ECMO), prolonged length of stay, and need for tracheostomy. However, identifying which infants are at increased risk can be challenging. In this study, we sought to investigate the utility of the inotropic score (IS) and vasoactive inotropic score (VIS) as tools to predict significant clinical outcomes and overall survival in patients with CDH. Additionally, we evaluated the correlation between IS/VIS and postnatal echocardiographic variables.

          Methods

          This was a retrospective chart review of 57 patients with CDH whose postnatal care was based on a standardized institutional protocol. We calculated the IS/VIS at 6-, 12-, 24-, 48 hours of life (HOL), on the day of CDH repair and 24- and 48 hours after surgical repair. The association of these scores with postnatal echocardiographic markers was analyzed using Pearson's correlation and linear regression, while logistic regression was used for binary outcomes, and Cox proportional hazards regression was used to assess associations with survival.

          Results

          We found that every one-unit increase in IS/VIS at 6 HOL was associated with 13% increase in the odds of ECMO ( p = 0.034) and 10.1% increase in risk of death ( p = 0.021). An increase in IS/VIS at 12-, 24- and 48-HOL was associated with posterior septal bowing in the first postnatal echocardiogram ( p < 0.05 for all). Additionally, we noted an inverse relationship between IS ( r = −0.281, p = 0.036) and VIS ( r = −0.288, p = 0.031) on the day of repair and left ventricle (LV) systolic function in first postnatal echocardiogram. Increase in IS ( r = −0.307, p = 0.024) and VIS ( r = −0.285, p = 0.037) on the day of repair was associated with decreased LV function on the post-repair echocardiogram.

          Conclusion

          This retrospective study showed a significant association between IS/VIS obtained at various time points with clinical outcomes and echocardiographic findings in CDH, which could be used to guide prognosis and management in this patient population.

          Related collections

          Most cited references27

          • Record: found
          • Abstract: found
          • Article: not found

          Vasoactive-inotropic score as a predictor of morbidity and mortality in infants after cardiopulmonary bypass.

          Michael Gaies, James G. Gurney, Alberta Yen … (2010)
          Inotrope score has been proposed as a marker of illness severity after pediatric cardiac surgery despite a lack of data to support its use as such. The goal of this study was to determine the association between inotropic/vasoactive support and clinical outcome in infants after cardiac surgery. Retrospective chart review. Dedicated pediatric cardiothoracic intensive care unit at an academic, tertiary care medical center. One hundred seventy-four patients 0 to 6 months of age admitted to the cardiothoracic intensive care unit after cardiac surgery with cardiopulmonary bypass between August 2007 and June 2008. Forty-three percent were neonates, and 39% had functional single ventricle physiology. None. Hourly doses of all vasoactive medications were recorded for the first 48 hrs after admission to the cardiothoracic intensive care unit and a vasoactive-inotropic score was calculated. The maximum vasoactive-inotropic score level over the first 48 hrs was a good predictor of poor clinical outcome (death, cardiac arrest, mechanical circulatory support, renal replacement therapy, and/or neurologic injury). After controlling for diagnosis, high maximum vasoactive-inotropic score was strongly associated with a poor outcome with an adjusted odds ratio of 8.1 (95% confidence interval, 3.4-19.2; p < .001) compared with patients with a low maximum vasoactive-inotropic score. High vasoactive-inotropic score was also associated with prolonged cardiothoracic intensive care unit stay, duration of mechanical ventilation, and time to negative fluid balance. The amount of cardiovascular support in the first 48 hrs after congenital heart surgery with cardiopulmonary bypass predicts eventual morbidity and mortality in young infants. The degree of support is best characterized by a maximum vasoactive-inotropic score obtained during this period. The usefulness of vasoactive-inotropic score as an independent predictor of clinical outcome in infants after cardiac surgery may have important implications for future cardiothoracic intensive care unit research.
          Article 0 comments Cited 189 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: not found
            • Article: not found

            Targeted Neonatal Echocardiography in the Neonatal Intensive Care Unit: practice guidelines and recommendations for training. Writing Group of the American Society of Echocardiography (ASE) in collaboration with the European Association of Echocardiography (EAE) and the Association for European Pediatric Cardiologists (AEPC).

            Luc Mertens, Istvan Seri, Jan Marek … (2011)
            Article 0 comments Cited 74 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Vasoactive-inotropic score is associated with outcome after infant cardiac surgery: an analysis from the Pediatric Cardiac Critical Care Consortium and Virtual PICU System Registries.

              Michael Gaies, Howard E Jeffries, Robert Niebler … (2014)
              To empirically derive the optimal measure of pharmacologic cardiovascular support in infants undergoing cardiac surgery with bypass and to assess the association between this score and clinical outcomes in a multi-institutional cohort.
              Article 0 comments Cited 69 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Contributors
                Journal
                Journal ID (nlm-ta): Front Pediatr
                Journal ID (iso-abbrev): Front Pediatr
                Journal ID (publisher-id): Front. Pediatr.
                Title: Frontiers in Pediatrics
                Publisher: Frontiers Media S.A.
                ISSN (Electronic): 2296-2360
                Publication date (Electronic): 01 February 2023
                Publication date Collection: 2023
                Volume: 11
                Electronic Location Identifier: 1101546
                Affiliations
                [ 1 ]Section of Neonatology, Department of Pediatrics, Baylor College of Medicine/Texas Children's Hospital , Houston, TX, United States
                [ 2 ]Department of Pharmacy, Texas Children's hospital , Houston, TX, United States
                [ 3 ]Section of Pediatric Cardiology, Department of Pediatrics, Baylor College of Medicine/Texas Children's Hospital , Houston, TX, United States
                [ 4 ]Department of Obstetrics and Gynecology, Maternal Fetal Medicine/Fetal Intervention Baylor College of Medicine , Houston, TX, United States
                [ 5 ]Department of Pediatric Surgery, Baylor College of Medicine/Texas Children's Hospital , Houston, TX, United States
                Author notes

                Edited by: Jason Gien, University of Colorado Anschutz Medical Campus, United States

                Reviewed by: Upender Munshi, Albany Medical College, United States Adrian Holloway, University of Maryland Medical Center, United States

                [* ] Correspondence: Sharada H. Gowda sharada.gowda@ 123456bcm.edu

                Specialty Section: This article was submitted to Neonatology, a section of the journal Frontiers in Pediatrics

                Article
                DOI: 10.3389/fped.2023.1101546
                PMC ID: 9929143
                PubMed ID: 36816370
                SO-VID: 1fc0def0-b853-4a3f-8136-6735055e5fb9
                Copyright © © 2023 Hari Gopal, Toy, Hanna, Furtun, Hagan, Nassr, Fernandes, Keswani and Gowda.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                Date received : 18 November 2022
                Date accepted : 10 January 2023
                Page count
                Figures: 4, Tables: 4, Equations: 0, References: 28, Pages: 0, Words: 0
                Categories
                Subject: Pediatrics
                Subject: Original Research

                Keywords: congenital diaphragmatic hernia,pulmonary hypertension,ventricular dysfunction,inotropic score,vasoactive inotropic score,extracorporeal membrane oxygenation
                Data availability:
                Keywords: congenital diaphragmatic hernia, pulmonary hypertension, ventricular dysfunction, inotropic score, vasoactive inotropic score, extracorporeal membrane oxygenation

                Comments

                Comment on this article

                scite_

                Similar content503

                See all similar

                Cited by1

                See all cited by

                Most referenced authors364

                See all reference authors