TY - JOUR
T1 - Prolonged central venous desaturation measured by continuous oximetry is associated with adverse outcomes in pediatric cardiac surgery
AU - Crowley, Ryan
AU - Sanchez, Elizabeth
AU - Ho, Jonathan K.
AU - Lee, Kate J.
AU - Schwarzenberger, Johanna
AU - Marijic, Jure
AU - Sopher, Michael
AU - Mahajan, Aman
N1 - Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2011/11
Y1 - 2011/11
N2 - Background: The role of continuous central venous oxygen saturation (ScvO2) oximetry during pediatric cardiac surgery for predicting adverse outcomes is not known. Using a recently available continuous ScvO2 oximetry catheter, we examined the association between venous oxygen desaturations and patient outcomes. We hypothesized that central venous oxygen desaturations are associated with adverse clinical outcomes. Methods: Fifty-four pediatric patients undergoing cardiac surgery were prospectively enrolled in an unblinded observational study. ScvO2 was measured continuously in the operating room and for up to 24 h post-Intensive Care Unit admission. The relationships between ScvO2 desaturations, clinical outcomes, and major adverse events were determined. RESULTS:: More than 18 min of venous saturations less than 40% were associated with major adverse events with 100% sensitivity and 97.6% specificity. Significant correlations resulted between the ScvO2 area under the curve less than 40% and creatinine clearance at 12 h in the Intensive Care Unit (r =-0.58), Intensive Care Unit length of stay (r = 0.56), max inotrope use (r = 0.52), inotrope use at 24 h (r = 0.40), inotrope index score (r = 0.39), hospital length of stay (r = 0.36), and length of intubation (r = 0.32). Conclusions: We demonstrate that ScvO2 desaturations by continuous oximetry are associated with major adverse events in pediatric patients undergoing cardiac surgery. The most significant associations with major adverse events are seen in patients with greater than 18 min of central venous saturations less than 40%. Our results support the further investigation of ScvO2 as a potential target parameter in high-risk pediatric patients to minimize the risk of major adverse events.
AB - Background: The role of continuous central venous oxygen saturation (ScvO2) oximetry during pediatric cardiac surgery for predicting adverse outcomes is not known. Using a recently available continuous ScvO2 oximetry catheter, we examined the association between venous oxygen desaturations and patient outcomes. We hypothesized that central venous oxygen desaturations are associated with adverse clinical outcomes. Methods: Fifty-four pediatric patients undergoing cardiac surgery were prospectively enrolled in an unblinded observational study. ScvO2 was measured continuously in the operating room and for up to 24 h post-Intensive Care Unit admission. The relationships between ScvO2 desaturations, clinical outcomes, and major adverse events were determined. RESULTS:: More than 18 min of venous saturations less than 40% were associated with major adverse events with 100% sensitivity and 97.6% specificity. Significant correlations resulted between the ScvO2 area under the curve less than 40% and creatinine clearance at 12 h in the Intensive Care Unit (r =-0.58), Intensive Care Unit length of stay (r = 0.56), max inotrope use (r = 0.52), inotrope use at 24 h (r = 0.40), inotrope index score (r = 0.39), hospital length of stay (r = 0.36), and length of intubation (r = 0.32). Conclusions: We demonstrate that ScvO2 desaturations by continuous oximetry are associated with major adverse events in pediatric patients undergoing cardiac surgery. The most significant associations with major adverse events are seen in patients with greater than 18 min of central venous saturations less than 40%. Our results support the further investigation of ScvO2 as a potential target parameter in high-risk pediatric patients to minimize the risk of major adverse events.
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U2 - 10.1097/ALN.0b013e318233056e
DO - 10.1097/ALN.0b013e318233056e
M3 - Article
C2 - 21952253
AN - SCOPUS:80054991083
SN - 0003-3022
VL - 115
SP - 1033
EP - 1043
JO - Anesthesiology
JF - Anesthesiology
IS - 5
ER -