Abstract P-544: PRE-OPERATIVE BIOELECTRICAL IMPEDANCE PREDICTS INTENSIVE CARE LENGTH OF STAY IN CHILDREN FOLLOWING CARDIAC SURGERY

Abstract

Aims & Objectives: Following cardiac surgery for congenital heart disease (CHD), there are many factors known to influence paediatric intensive care unit length of stay (PICU-LOS). Objective pre-operative assessments may more accurately identify those children at risk of prolonged PICU stay and facilitate specific PICU management strategies, allowing for better utilisation of PICU resources. The aim was to investigate the predictive value of a pre-operative measures of bioelectrical impedance spectroscopy phase angle (BIS-PA) 200/50 in children admitted to PICU following cardiac surgery to predict PICU-LOS. Methods Children (0 – 16 years) with CHD undergoing cardiac surgery were prospectively enrolled at a single tertiary centre. BIS-PA measurements were collected at baseline (day before surgery). Fluid balance was recorded in the post-operative phase. Results BIS PA 200/50 measurements were obtained in 50 children. Moderate malnutrition height-for-age Z score ≤-2; 16% of children met this. Significant positive correlations: PICU-LOS and BIS PA 200/50 (n=50, r=0.46, p<0.001) and fluid balance on day 0 (n=50, r=0.46, p<0.001). There were significant correlations between BIS PA 200/50 and fluid balance on day 0 (n=50, r=-0.3, p=0.03) and height for age z score (n=50, r=-0.3, p=0.03). BIS PA 200/50 remained statistically associated with PICU-LOS when entered into a linear regression model (p=0.029). Conclusions In this study we were able to demonstrate a statistically significant relationship between BIS PA 200/50 and PICU-LOS of stay and positive fluid balance the day following surgery. A pre-operative objective estimate of risk may allow for earlier the identification and more targeted fluid management therapy during the post-operative period.