Standardized Treatment andDiagnostic Approach to Reduce Disease burden in the early postoperative phase in children with congenital heart defects-STANDARD study: a pilot randomized controlled trial

被引:1
作者
Vogt, Antonia [1 ]
Meyer, Sascha [2 ]
Schaefers, Hans-Joachim [3 ]
Weise, Julius Johannes [4 ]
Wagenpfeil, Stefan [4 ]
Abdul-Khaliq, Hashim [5 ]
Poryo, Martin [5 ]
机构
[1] Univ Saarland, Med Sch, Homburg Saar, Germany
[2] Stadt Klinikum Karlsruhe, Franz Lust Klin Kinder & Jugendmed, Karlsruhe, Germany
[3] Saarland Univ, Dept Thorac & Cardiovasc Surg, Med Ctr, Homburg Saar, Germany
[4] Saarland Univ, Inst Med Biometry Epidemiol & Med Informat, Med Ctr, Homburg Saar, Germany
[5] Saarland Univ, Dept Pediat Cardiol, Med Ctr, Kirrberger Str,Bldg 9, D-66421 Homburg Saar, Germany
关键词
Congenital heart defect; Congenital heart surgery; Daily goals; Intensive care unit length of stay; VASOACTIVE-INOTROPIC SCORE; DIRECTED HEMODYNAMIC THERAPY; INTENSIVE-CARE-UNIT; DAILY GOALS; MULTIDISCIPLINARY ROUNDS; IMPROVING COMMUNICATION; RISK; SURGERY; PREVALENCE; MORTALITY;
D O I
10.1007/s00431-023-05191-x
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
To explore the effect of a daily goal checklist on pediatric cardiac intensive care unit (PCICU) length of stay (LOS) after congenital heart surgery. This study is a prospective randomized single-center study. Group characteristics were as follows: STANDARD group: n = 30, 36.7% female, median age 0.9 years; control group: n = 33, 36.4% female, median age 1.1 years. Invasive ventilation time, STAT categories, mean vasoactive-inotropic score (VIS) (24h), maximal (max.) VIS24h, mean VIS24-48h, max. VIS24-48h, VIS category, number of sedatives, analgesics, diuretics, number of deployed diagnostic modalities, morbidities, and mortality did not differ between both groups. Median PCICU LOS was 96.0 h (STANDARD group) versus 101.5 h (control group) (p = 0.63). In the overall cohort, univariate regression analysis identified age at surgery (b = -0.02), STAT category (b = 18.3), severity of CHD (b = 40.6), mean VIS24h (b = 3.5), max. VIS24h (b = 2.2), mean VIS24-48h (b = 6.5), and VIS category (b = 13.8) as significant parameters for prolonged PCICU LOS. In multivariate regression analysis, age at surgery (b = -0.2), severity of CHD (b = 44.0), and mean VIS24h (b = 6.7) were of significance. Within the STANDARD sub-group, univariate regression analysis determined STAT category (b = 32.3), severity of CHD (b = 70.0), mean VIS24h (b = 5.0), mean VIS24-48h (b = 5.9), number of defined goals (b = 2.6), number of achieved goals (b = 3.3), number of not achieved goals (b = 10.8), and number of unevaluated goals (b = 7.0) as significant parameters for prolonged PCICU LOS. Multivariate regression analysis identified the number of defined goals (b = 2.5) and the number of unevaluated goals (b = - 3.0) to be significant parameters. Conclusion: The structured realization and recording of daily goals is of advantage in patients following pediatric cardiac surgery by reducing PCICU LOS.
引用
收藏
页码:5325 / 5340
页数:16
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