Präoperative Azidose und Entwicklung von Säuglingen nach Operation angeborener Herzfehler Preoperative acidosis and infant development following surgery for congenital heart disease.

Details

Serval ID
serval:BIB_6DD4C3B54BEB
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Präoperative Azidose und Entwicklung von Säuglingen nach Operation angeborener Herzfehler Preoperative acidosis and infant development following surgery for congenital heart disease.
Journal
Herz
Author(s)
Verheijen P.M., Lisowski L.A., Wassink S., Visser G.H., Meijboom E.J.
ISSN
1615-6692[electronic], 0340-9937[linking]
Publication state
Published
Issued date
2010
Volume
35
Number
5
Pages
358-362
Language
english
Abstract
OBJECTIVE: Prenatal diagnosis has been shown to decrease pre-operative acidosis and might prevent the occurrence of disturbed developmental outcome. The aim of this study is to evaluate parameters for acidosis and their predictive value on developmental outcome in newborns with congenital heart disease.
METHODS: A total of 117 patients requiring surgery for structural heart disease in the first 31 days of life were included. Diagnosis was established either pre- or postnatally. Preoperative values of lactate, pH and base excess levels were compared to the occurrence of disturbed developmental outcome, i.e. an underperformance of more than 10% on the P90 of a standardized Dutch developmental scale. Patients were divided into groups according to blood levels of acidosis parameters, using receiver operating characteristics curves to determine cut-off values for pH, base excess and lactate.
RESULTS: No significant difference in developmental outcome was found using values for pH or base excess as a cut-off level. Preoperative lactate values exceeding 6.1 mmol/l resulted in a significant increase in impaired development compared to infants with a pre-operative lactate lower than 6.1 mmol/l: 40.9% vs 15.1% in (p=0.03).
CONCLUSIONS: Pre-operative lactate values might have a prognostic value on developmental outcome in newborns with congenital heart disease. The limited prognostic value of pH can be explained by the fact that pH can be easily corrected, while lactate better reflects the total oxygen debt experienced by these patients.
Keywords
prenatal-diagnosis, children, lactate, mortality, complications, obstruction, morbidity, newborn, fetuses, period, Development, Congenital heart disease, Acidosis, Prenatal diagnosis, Lactate
Pubmed
Web of science
Create date
08/09/2010 15:28
Last modification date
20/08/2019 14:27
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