Value of troponin T measurements for prediction of postoperative course and length of ICU stay of children after surgical correction of congenital heart disease.

Abstract

The development of surgical and anaesthetic techniques improved the outcomes in children with congenital heart disease (CHD). After repair of defects using cardiopulmonary bypass (CPB) children often require prolonged respiratory or inotropic support in the intensive care unit (ICU). The aim of the study was to assess troponin T (TnT) values as a predictor of postoperative requirements and ICU length of stay (ICU-LOS) after cardiac surgery. We included 41 patients who underwent corrective surgery for CHD between August and December 2017. TnT level was measured after induction of anaesthesia, 12 h after CPB (t2) and 24 h following CPB (t3). The Aristotle Basic Score for procedure complexity was calculated, total times of CPB and aortic cross-clamping were measured, and maximal Vasoactive-Inotropic Score and ICU-LOS were determined. Statistical relationships between TnT levels and the mentioned parameters were estimated. The median age of the patients was 37 months (14 days to 17 years). Three patients died. The median ICU-LOS was 42.7 hours. A positive correlation was found between ICU-LOS and TnT values at t2 ( Rs = 0.62, P = 0.008) and t3 ( Rs = 0.44, P = 0.018). TnT concentrations at t2 correlated significantly with: Aristotle score ( Rs = 0.50, P = 0.001), total time of CPB ( R s =0.58, P = 0.001), CC time ( Rs = 0.47, P = 0.002) and VIS ( Rs = 0.42, P = 0.001). TnT levels did not discriminate between survivors and non-survivors. Troponin T concentration is a useful tool to anticipate postoperative course and ICU-LOS in children after cardiac surgery.