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Predictors for use of temporary epicardial pacing wires after pediatric cardiac surgery.
- Source :
-
The Journal of thoracic and cardiovascular surgery [J Thorac Cardiovasc Surg] 2012 Sep; Vol. 144 (3), pp. 557-62. Date of Electronic Publication: 2012 Feb 11. - Publication Year :
- 2012
-
Abstract
- Objective: The objectives of this study were (1) to determine the use of temporary epicardial pacing wires to diagnose and treat early postoperative arrhythmias in pediatric cardiac surgical patients and (2) to determine the predictive factors for the need of pacing wires for diagnostic or therapeutic purposes.<br />Methods: We collected preoperative, intraoperative, and postoperative data in a prospective, observational format from patients undergoing pediatric cardiac surgery between August 2010 and January 2011 at a single academic children's hospital.<br />Results: A total of 157 patients met the inclusion criteria during the study period. Of these 157 patients, pacing wires were placed in 127 (81%). Pacing wires were used in 25 patients (19.6%) for diagnostic purposes, 26 patients (20.4%) for therapeutic purposes, 15 patients (11.8%) for both diagnostic and therapeutic purposes, and 36 patients (28.3%) for diagnostic or therapeutic purposes. Need for cardioversion in the operating room, presence of 2 or more intracardiac catheters, severely reduced ventricular ejection fraction, and elevated serum lactate level at the time of operating room discharge were found to be independent predictors for the use of pacing wires. The only complication noted in the cohort was a skin infection at a pacing wire insertion site in 1 patient. A permanent pacemaker was required in 8 (6.2%) of all patients with temporary pacing wires.<br />Conclusions: Our data support the use of temporary epicardial pacing wires in approximately 30% of children after congenital heart surgery. We found the need for cardioversion in the operating room, presence of 2 or more intracardiac catheters, severely reduced ventricular ejection fraction, and high serum lactate level at the time of discharge from the operating room to be independent predictors of the use of pacing wires in the early postoperative period.<br /> (Copyright © 2012 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.)
- Subjects :
- Academic Medical Centers
Arrhythmias, Cardiac diagnosis
Arrhythmias, Cardiac etiology
Arrhythmias, Cardiac physiopathology
Biomarkers blood
California
Cardiac Catheterization adverse effects
Chi-Square Distribution
Child
Child, Preschool
Device Removal
Electric Countershock adverse effects
Electrodes, Implanted
Equipment Design
Female
Heart Defects, Congenital physiopathology
Humans
Infant
Infant, Newborn
Lactic Acid blood
Logistic Models
Male
Multivariate Analysis
Odds Ratio
Predictive Value of Tests
Prospective Studies
Risk Assessment
Risk Factors
Stroke Volume
Time Factors
Treatment Outcome
Arrhythmias, Cardiac therapy
Cardiac Pacing, Artificial adverse effects
Cardiac Surgical Procedures adverse effects
Heart Defects, Congenital surgery
Pacemaker, Artificial adverse effects
Pericardium physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 1097-685X
- Volume :
- 144
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- The Journal of thoracic and cardiovascular surgery
- Publication Type :
- Academic Journal
- Accession number :
- 22329984
- Full Text :
- https://doi.org/10.1016/j.jtcvs.2011.12.060