Revista medica del Instituto Mexicano del Seguro Social · 2014
[Mortality-associated factors in pediatric patients with Blalock-Taussig shunt].
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Aguilar-Segura Perla Roxana, Lazo-Cárdenas César, Rodríguez-Hernández Lydia, Márquez-González Horacio, Giménez-Scherer Juan Antonio
Аннотация
BACKGROUND: Congenital heart disease with decreased pulmonary flow survival has increased due to systemic pulmonary fistulae (SPF); nevertheless, complications may occur. The purpose of this study was to identify mortality-related surgical and biochemical factors in pediatric patients with modified Blalock-Taussig shunt.
METHODS: A cohort was formed with congenital heart disease newborns who survived Blalock-Taussig-type palliative systemic pulmonary fistulae surgery. At admission to the intensive care unit, surgical time, diameter polytetrafluoroethylene vascular graft, arterial blood gases and central venous saturation were recorded. The patients were followed until discharge or death. For statistical analysis, central tendency and dispersion measures, chi-square tests, odds-ratios, Cox regression model and hazard ratios (HR) were used, and for the most independent variable, Kaplan-Meier curves.
RESULTS: Out of 33 newborns who underwent the surgical procedure, 9 died (23%). The most common heart diseases were pulmonary atresia with intact ventricular septum (8 patients, 25%) and hypoplastic right ventricle (8, 25%). The most independent mortality-associated variable was hyperlactatemia > 3 mmol/L (HR = 8 [1.9 - 32], p < 0.05).
CONCLUSIONS: Lactate > 3 mmol/L was an independent predictor of mortality in patients who underwent Blalock-Taussig shunt.
METHODS: A cohort was formed with congenital heart disease newborns who survived Blalock-Taussig-type palliative systemic pulmonary fistulae surgery. At admission to the intensive care unit, surgical time, diameter polytetrafluoroethylene vascular graft, arterial blood gases and central venous saturation were recorded. The patients were followed until discharge or death. For statistical analysis, central tendency and dispersion measures, chi-square tests, odds-ratios, Cox regression model and hazard ratios (HR) were used, and for the most independent variable, Kaplan-Meier curves.
RESULTS: Out of 33 newborns who underwent the surgical procedure, 9 died (23%). The most common heart diseases were pulmonary atresia with intact ventricular septum (8 patients, 25%) and hypoplastic right ventricle (8, 25%). The most independent mortality-associated variable was hyperlactatemia > 3 mmol/L (HR = 8 [1.9 - 32], p < 0.05).
CONCLUSIONS: Lactate > 3 mmol/L was an independent predictor of mortality in patients who underwent Blalock-Taussig shunt.