Effects of fluid overload on postoperative outcome of infant following cardiac surgery
10.3760/cma.j.issn.1001-4497.2018.03.004
- VernacularTitle:液体超负荷对婴儿先天性心脏病术后治疗结局的影响
- Author:
Deqiang LUO
1
;
Zili CHEN
;
Wei DAI
;
Shanshan LI
Author Information
1. 330004,江西省上饶市第五人民医院ICU
- Keywords:
Congenital heart disease;
Fluid overload;
Clinical outcome;
Infants
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2018;34(3):144-148
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore effects and cause of fluid overload on infant following cardiac surgery.Methods This is a single center,(ICU,the Great Wall Affiliated Hospital of Nanchang University)retrospective study,between April 2012 and April 2016,176 infants who aged less than 6 months undergoing pediatric cardiac surgery were included.During consecutive postoperative 7 days,comprehensive treatment strategy for infants following cardiac surgery was adopted,collecting clinical outcomes and calculating data of fluid overload;ROC curve analysising postoperative optimal cutoff value of fluid overload.Hospitalization mortality and the second clinical outcome including low cardiac output syndrome,days on mechanical ventilation,ICU length of stay and hospital length of stay were compared to find risk factors of fluid overload.Results 176 cases of infants included in the study.ROC curves for postoperative seven consecutive days time point of Fo determined the optimal cutoff values of 7.8 ％ for FO (A UC =0.69).The mortality and hospital length of stay is not significant difference between fluid overload above 7.8％ and below or equal to 7.8％,however,the incidence of low cardiac output syndrome was higher in infants with fluid overload above 7.8％,and longer duration of mechanical ventilation,ICU residence time.After multivariable analysis,the postoperative adverse outcomes was associated with low cardiac output syndrome and peak serum creatinine (P ＜ 0.05),and cumulative higher fluid overload on the second day after surgery was associated with postoperative acute kidney injury and low cardiac output syndrome(P ＜ 0.05,respectively).Conclusion Postoperative adverse outcomes in infants with congenital heart disease are associated with peak serum creatinine and low cardiac output syndrome;postoperative acute kidney injury and low cardiac output syndrome are the main causes of fluid overload.Shortening cardiopulmonary bypass time and maintaining fluid overload of postoperative day 2 below 7.8％ will help to the postoperative complications.
