Capillary Refill Time and Serum Lactate as Predictors of Mortality and Postoperative Extracorporeal Membrane Oxygenation Requirement in Congenital Heart Surgery.
Gustavo CruzSantiago Pedroza GómezAkemi Arango SakamotoPaula A GuevaraCarlos GonzálezJesus AguirreAndrea Valencia-OrozcoAntonio J SuguimotoPublished in: Children (Basel, Switzerland) (2023)
Multiple tissue perfusion markers are described to guide therapy in critically ill pediatric patients undergoing congenital heart surgery. Given the advantages of capillary refill time, our goal is to determine its predictive capacity for mortality and postoperative extracorporeal oxygenation requirements in congenital heart surgery and compare it to serum lactate. We conducted a prospective cohort observational study in a single high-complexity university hospital. Serum lactate and capillary refill time were measured at five predetermined time points: preoperative, immediate postoperative, 6, 12, and 24 h after the surgery. Prolonged immediate postoperative, 6 h, and 12 h capillary refill time measurements turned out to be independent risk factors for both outcomes. The capillary refill time area under the curve ranged between 0.70 and 0.80, while the serum lactate resulted between 0.79 and 0.92 for both outcomes. Both tissue perfusion markers resulted in mortality and extracorporeal oxygenation requirement predictors. Given the advantages of capillary refill time over serum lactate, a monitoring strategy including these two perfusion markers should be considered for congenital heart surgeries.
Keyphrases
- patients undergoing
- minimally invasive
- coronary artery bypass
- extracorporeal membrane oxygenation
- surgical site infection
- acute respiratory distress syndrome
- stem cells
- magnetic resonance
- magnetic resonance imaging
- contrast enhanced
- risk factors
- mesenchymal stem cells
- intensive care unit
- cell therapy
- computed tomography
- bone marrow
- percutaneous coronary intervention
- adipose tissue
- blood flow
- skeletal muscle
- glycemic control