CoChat
Sign Up
Cited by 152Hemodynamic Monitoring and TherapyCongenital Heart Disease StudiesCardiac and Coronary Surgery Techniques

Early markers of major adverse events in children after cardiac operations

Open access
Duke, Trevor, Butt, Warwick, South, Mike, Karl, Tom R.·1997·The Journal of Thoracic and Cardiovascular Surgery
DOI 10.1016/s0022-5223(97)70018-7
Open this paper in CoChat — free accountOpen PDF

Abstract

Objectives The purpose of this study was to determine the physiologic variables that predict major adverse events in children in the intensive care unit after cardiac operations.Methods A cohort observational study was conducted. At the time of admission to the intensive care unit and 4, 8, 12, and 24 hours later the following variables were recorded: mean arterial pressure, heart rate, cardiac index, oxygen delivery, mixed venous oxygen saturation, base deficit, blood lactate, gastric intramucosal pH, carbon dioxide difference (the difference between arterial carbon dioxide tension and gastric intraluminal carbon dioxide tension), and toe-core temperature gradient. Major adverse events were prospectively identified as cardiac arrest, need for emergency chest opening, development of multiple organ failure, and death.Results Ninety children were included in the study; 12 had major adverse events and there were 4 deaths. Blood lactate level, mean arterial pressure, and duration of cardiopulmonary bypass were the only significant, independent predictors of major adverse events when measured at the time of admission to the intensive care unit. The odds ratio (95% confidence intervals) for major adverse events if a lactate level was greater than 4.5 mmol/L was 5.1 (1.2 to 21.1), for admission hypotension 2.3 (0.5 to 9.8), and for a cardiopulmonary bypass time greater than 150 minutes 13.7 (3.3 to 57.2). Four hours after admission lactate and carbon dioxide difference, and 8 hours after admission lactate and base deficit, were independently significant predictors. The odds ratios for major adverse events if the blood lactate level was greater than 4 mmol/L at 4 and 8 hours were 8.3 (1.8 to 38.4) and 9.3 (1.9 to 44.3), respectively. At no time in the first 24 hours were cardiac output, oxygen delivery, mixed venous oxygen saturation, toe-core temperature gradient, or heart rate significant predictors of major adverse events.Conclusions In the context of our current treatment strategies, the duration of cardiopulmonary bypass and blood lactate level, measured in the early postoperative period, were the best predictors of impending major adverse events.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1016/s0022-5223(97)70018-7

Cites

26 of 26 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Other studies did not find any statistically significant associations between CPTd and hemodynamic parameters.

    “Nonetheless, other studies did not find any statistically significant associations [28,29].”

    From Trends and Challenges in Noninvasive Hemodynamic Monitoring of Neonates Following Cardiac Surgery: A Narrative Review (2025) · cites this paper as [28]

    The ‘Prediction of MAE with admission values of physiologic variables’ section reports no statistically significant association between the toe-core temperature gradient and major adverse events. It does not test an association between that gradient (CPTd) and hemodynamic parameters; searches for such a correlation found no passage addressing it. (LLM, conf=0.73)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

1 of the 27 references couldn’t be matched to a known paper.

Cited by

Sorted by citations

Related

Authors
Duke, T., Butt, W., South, M., & Karl, T. R.
Affiliations
Royal Children's Hospital (AU)
ORCID
Venue
The Journal of Thoracic and Cardiovascular Surgery
Publisher
Elsevier BV
Published
1997-12
Volume
114
Issue
6
Pages
1042-1052
ISSN
0022-5223 (ISSN-L)
DOI
10.1016/s0022-5223(97)70018-7
OpenAlex
W1976190220
Cited by
152
References
27
Citations by year
2026: 2 · 2025: 4 · 2024: 1 · 2023: 2 · 2022: 6 · 2021: 6 · 2020: 2 · 2019: 3 · 2018: 5 · 2017: 4 · 2016: 4 · 2015: 3 · 2014: 6 · 2013: 6 · 2012: 8
FWCI
6.14
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Thoracic and Cardiovascular Surgery (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Hemodynamic Monitoring and Therapy
  • Health Sciences › Medicine › Epidemiology › Congenital Heart Disease Studies
  • Health Sciences › Medicine › Surgery › Cardiac and Coronary Surgery Techniques
Keywords
pediatric cardiac surgery, early warning indicators, blood lactate, cardiopulmonary bypass time, hypotension, cardiac arrest, multiple organ failure, intensive care unit, cardiac output, base deficit, gastric intramucosal pH, mixed venous oxygen saturation
MeSH terms
Blood Pressure, Cardiopulmonary Bypass, Heart Arrest, Cardiac Surgical Procedures, Humans, Infant, Multiple Organ Failure, Postoperative Complications, Predictive Value of Tests, Reoperation, Risk Factors, Time Factors, Intensive Care Units, Pediatric, Cohort Studies, Sepsis, Lactic Acid

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review