Abstract
To examine the usefulness of gastric intramucosal pH (pHi) to predict adverse events during the postoperative period after cardiac surgery in pediatric patients. Prospective, observational clinical study. Multidisciplinary pediatric intensive care unit, university hospital. A total of 70 patients who had elective cardiac surgery and cardiopulmonary bypass; mean age, 4.0 yrs. Gastric tonometry. In all cases, the pHi was determined within the first 2 hrs and again within the first 12 hrs of the postoperative period after cardiac surgery. The following adverse events were considered: mortality, multiple organ failure (MOF), and infectious complications. Patients were divided into three groups: Group A, patients having the two pHi measurements < or =7.32 (n = 15); Group B, patients having the two pHi determinations >7.32 (n = 28); and Group C, patients having one pHi determination < or =7.32 and the other >7.32 (n = 27). Of the total sample, 5 (7.1%) patients died; 4 (5.7%) had MOF, and 13 (18.5%) had infectious complications. When the rate of adverse events was analyzed in the three groups, significant differences were found in mortality (p < .035) and MOF (p < .029). This was not the case for infectious complications (p = .071). In Group A, three patients died and three had MOF. The standardized chi-square values were 1.87 and 2.31 respectively, causing the authors to consider that this group accounted for the differences found in the global analysis. Two pHi determinations < or =7.32, one at admission and one at 12 hrs of the postoperative period after cardiac surgery and cardiopulmonary bypass, were associated with a higher rate of mortality and MOF, but not with a higher rate of infectious complications. It is not yet possible to recommend the use of this finding as a treatment objective to guide hemodynamic optimization in this group of patients.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.