1.Correlation analysis of central venous oxygen saturation-related indexes at different time points with low cardiac output syndrome in children after congenital heart disease correction surgery
Jingxiao LI ; Yunkai CAI ; Binfeng LEI ; Wei LU ; Liqin MO ; Weifeng HUANG ; Chaohai LYV ; Liuying QIN ; Jingwei JIANG ; Ting ZHOU
Chongqing Medicine 2025;54(5):1155-1160
Objective To explore the correlation between central venous oxygen saturation(ScvO2)-re-lated indexes at different time points and the occurrence of low cardiac output syndrome(LCOS)after con-genital heart disease(CHD)correction surgery.Methods A total of 73 children who underwent CHD correc-tion surgery in this hospital from July 1st,2021 to July 1st,2024 were selected as the research subjects.The clinical data,preoperative conditions,and postoperative conditions of the children were collected.The ScvO2 and arterial lactate(Lac)levels of the children at different time points(the 1st,6th,12th,and 24th hours after surgery)were monitored,and the ScvO2/Lac at different time points and the change rate of ScvO2 in different time periods were calculated.The correlation between ScvO2-related indexes and LCOS after CHD correction surgery was analyzed.Results ScvO2 at the 6th hour after surgery,ScvO2 at the 12th hour after surgery,Sc-vO2/Lac at the 12th hour after surgery,the change rate of ScvO2 from the 1st to the 24th hour after surgery,the change rate of ScvO2 from the 6th to the 12th hour after surgery,and the change rate of ScvO2 from the 12th to the 24th hour after surgery were independent influencing factors of LCOS occurrence after CHD cor-rection surgery(P<0.05).There was a negative correlation between ScvO2 at the 12th hour after surgery,ScvO2/Lac and LCOS occurrence after CHD correction surgery(r=-0.543,-0.523,P<0.05).The area under the curve(AUC)of ScvO2 at the 12th hour after surgery for predicting LCOS occurrence after CHD correction surgery was 0.938(95%CI:0.865-1.000);the AUC of ScvO2/Lac at the 12th hour after surgery for predicting LCOS occurrence after CHD correction surgery was 0.922(95%CI:0.851-0.994).Conclusion ScvO2 and ScvO2/Lac at the 12th hour after surgery have good predictive potential for LCOS occurrence af-ter CHD correction surgery.
2.Surgical treatment for acute aortic syndrome and discussion on several problems
Wei LU ; Baoshi ZHENG ; Binfeng LEI ; Xiaoyong XIE ; Jun PENG ; Liuliu HUANG ; Cheng LUO
Chinese Journal of Thoracic and Cardiovascular Surgery 2017;33(10):591-593
Objective To summarize seven-year experience in therapy for acute aortic syndrome.Methods Between May 2009 and June 2016,103 patients(75 males and 28 females)diagnosed as acute aortic syndrome underwent operation. The mean age was(43.13 ±15.07)years(20 -79 years).We applied hypothermic circulatory arrest and selective antegrade cerebral perfusion to achieve organic protection.92 patients underwent Sun's procedure.Bentall procedure was performed on 63 patients.9 patients accepted aortic valve repair or root plasty.Mitral valve was replaced in 5 patients.Right coronary artery bypass grafting was carried out on 3 patients.Results Mean cardiopulmonary bypass time was(231.7 ±55.9)min, and cross-clamp time was(138.1 ±31.3)min.Selective cerebral perfusion time was(31.0 ±6.8)min.9 patients died within postoperative 30-days.Conclusion Despite of progression of treatment on acute aortic syndrome, further researches are still required for severe complications and strategies of therapy.
3.Risk Factor Analysis of Acute Kidney Injury After Isolated Heart Valve Prosthesis Implantation in Relevant Patients
Xianzeng XU ; Ting ZHOU ; Yangchun LIU ; Jing QIAN ; Xiaoyong XIE ; Binfeng LEI ; Xu FENG ; Baoshi ZHENG
Chinese Circulation Journal 2016;31(8):785-788
Objective: To analyze the risk factors of acute kidney injury (AKI) after isolated heart valve prosthesis implantation (HVPI) in relevant patients. Methods: We retrospectively studied 400 patients who received isolated HVPI in our hospital. The demographic characteristics and pre-, intra-, post-operative information were collected to conduct uni- and multi-variantanalysis. Results: The pre-operative serum creatinine level in 400 patients was 85.0 (72.0, 98.0) μmol/L and post-operative level was 104.5 (80.0, 146.3) μmol/L, the elevation was 20.9% (1.6%, 57.9%),P<0.05. Multi Logistic regression analysis indicated that age>50years (OR=2.12, 95% CI 1.13-3.95),hypertension history (OR=4.07, 95% CI1.23-13.47), cardiopulmonary bypass time>180 minutes (OR=5.38, 95% CI 1.63-17.77), post-operative hemoglobin<70 g/L (OR=0.20, 95% CI 0.06=0.74), serum glutamic-pyruvic transaminase>100 u/L (OR=12.10, 95% CI 2.28-64.23), pleural fluid drainage at the day of operation> 500 ml (OR=2.12, 95% CI 1.13-3.95), extubation after 24 hours of operation (OR=3.94, 95% CI 2.07-7.52), combining low cardiac output syndrome (OR=4.64, 95% CI 1.06-20.29) were the independent risk factors for AKI occurrence in patients after HVPI, allP<0.05. Conclusion: Post-HVPI AKI was associated with many factors. At prior operation, it was mainly related to the age and hypertension; during theoperation, it was mainly related to cardiopulmonary bypass time; at post-operation, it was mainly related to delayed extubation, low cardiac outputsyndrome, anemia, increased pleural lfuid drainage and serum glutamic-pyruvic transaminase.

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