The Application and Benefits of C-CHEWS in Infants with Left-to-Right Shunt Congenital Heart Disease during the Transition Period after Surgery.

OBJECTIVE

This study aimed to explore the predictive value of various indicators in the application of C-CHEWS (Cardiac-Children's Hospital Early Warning Score) during the transition period of infants with left-to-right shunt congenital heart disease after surgery.

METHODS

A retrospective study was conducted on 229 infants who underwent surgery for left-to-right shunt congenital heart disease at a tertiary pediatric hospital in Anhui Province from January 2019 to March 2022. The infants' status was evaluated using C-CHEWS scores within 1 hour of transfer from the ICU to the transitional ward. A cutoff score 6 was used, with scores ≤6 defining the control group and scores ≥7 defining the observation group. The predictive value of various indicators during this period was analyzed.

RESULTS

The 229 infant patients were divided into the control group (n = 154) and the observation group (n = 75). All infants received sufficient oxygen inhalation, and 210 infants underwent VIS (Vasoactive-inotropic Score) evaluation, with 137 in the control group and 73 in the observation group, showing a statistically significant difference between the two groups. All infants were discharged without recurrence of ICU admission within 48 hours. In the C-CHEWS evaluation, medical staff attention and parental concern were assigned 1 point, while the consciousness level received 0 points. The respiratory system scores ranged from 2 to 3 points without a statistically significant difference, whereas the cardiovascular system scores ranged from 0 to 3 points and showed a statistically significant difference. Among the 75 observation group patients, 43 were boys, accounting for 57.33%.

CONCLUSIONS

During the transition period after surgery for congenital heart disease in infants, monitoring the cardiovascular system, along with the effective application of VIS, through C-CHEWS scoring, can help detect warning signs. Focusing on managing cardiovascular function is crucial to reduce the risk of disease deterioration, promoting comfort, and aiding in the infants' recovery.