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Cardiac performance and mortality early after intracardiac surgery in infants and young children.
Open accessAbstract
One hundred thirty-nine infants and small children less than 48 months old were studied during the first 72 hours after intracardiac surgery for a variety of lesions. The hospital mortality rate was 19.4% (27 patients); 16 of those dying succumbed from acute cardiac failure. Deaths from acute cardiac failure were commonest in patients with low cardiac index (CI), and a continuous probability curve relates the two. The mean CI for all patients was 2.51 plus or minus 0.794 l-min minus 1-m minus 2, and that for individual patients varied between 0.6 and 4.9. Cardiac output normalized by surface area (cardiac index) correlated weakly with age. cardiac output normalized by weight did not correlate with age; Mean mixed venous oxygen partial pressure (P-vO2)varied between 17 and 60 mm Hg, and the weighted mean for the group of 80 patients in whom it was obtained was 33.1 plus or minus 6.57 mm Hg. CI and P-vO2 were only slightly related. Acute cardiac deaths occurred more frequently in patients with low P-vO2. Acute cardiac death was more reliably predicted using CI and P-vO2 together than either alone. The average of the mean arterial pressure was 80.5 plus or minus 2.53 mm Hg, and this did not correlate with CI. Mean average systemic vascular resistance was 30.0 plus or minus 8.395 SRU. We conclude that in such patients treatment should be directed toward keeping CI greater than 2.0 l-min minus 1-m minus 2 and P-vO2 greater than 30 mm Hg; that the possibility of maintaining adequate CI and P-vO2 is not related to the age of the patient but is related to the malformation treated; and that a therapeutic trial of reducing left ventricular afterload is indicated in some of these patients.
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“Approximately 25% of children experience a decrease in cardiac index of less than 2 L/min/m2 within 6-18 hours after cardiac surgery.”
From Management of the Low Cardiac Output Syndrome Following Surgery for Congenital Heart Disease (2016) · cites this paper as [1]
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Metadata
- Authors
- Parr, G. V., Blackstone, E. H., & Kirklin, J. W.
- Affiliations
- University of Alabama at Birmingham (US)
- Blackstone (United States) (US)
- ORCID
- Blackstone, E H
- Venue
- Circulation
- Published
- 1975-05
- Volume
- 51
- Issue
- 5
- Pages
- 867-874
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2001400624
- Cited by
- 210
- References
- 0
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 1 · 2023: 10 · 2022: 6 · 2021: 4 · 2020: 7 · 2019: 5 · 2018: 4 · 2017: 12 · 2016: 11 · 2015: 4 · 2014: 8 · 2013: 6 · 2012: 10
- FWCI
- 5.90
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Congenital Heart Disease Studies
- Health Sciences › Medicine › Surgery › Hemodynamic Monitoring and Therapy
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Cardiovascular Conditions and Treatments
- Keywords
- cardiac index, mortality, acute heart failure, systemic vascular resistance, cardiac output, infants, congenital heart disease, postoperative complications, left ventricular afterload, hemodynamic monitoring, mortality prediction
- MeSH terms
- Blood, Blood Pressure, Body Surface Area, Carbon Dioxide, Cardiac Output, Cardiopulmonary Bypass, Child, Preschool, Heart Arrest, Heart Defects, Congenital, Cardiac Surgical Procedures, Hemoglobins, Humans, Hydrogen-Ion Concentration, Hypothermia, Induced, Infant, Infant, Newborn, Oxygen, Oxygen Consumption, Postoperative Care, Postoperative Complications, Pulmonary Artery, Pulmonary Edema, Time Factors, Vascular Resistance
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 ›
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