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Vasoactive-ventilation-renal score in predicting outcome postcardiac surgery in children
Open accessAbstract
OBJECTIVE: The objective of this study was to evaluate vasoactive-ventilation-renal (VVR) score to predict outcome postcardiac surgery in children and establish the time at which the score is best to predict outcome. MATERIALS AND METHODS: percentile) and ICU mortality. Correlation between the outcome and scores was obtained and receiver operating characteristic (ROC) curves generated. Independent association of the scores with the outcome was also established. RESULTS: = 0.000). CONCLUSION: VVR score is effective and robust bedside method to predict prolonged LOS and mortality postpediatric cardiac surgery. VVR score at 48 h was the best to predict outcome.
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The VVR score has shown utility in predicting postoperative outcomes and mortality in pediatric cardiac surgery patients.
“The VVR score has shown utility in predicting postoperative outcomes and mortality in pediatric cardiac surgery patients [45].”
From Trends and Challenges in Noninvasive Hemodynamic Monitoring of Neonates Following Cardiac Surgery: A Narrative Review (2025) · cites this paper as [45]
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Vasoactive-Inotropic Score: Evolution, Clinical Utility, and Pitfalls
Belletti, A., Lerose, C. C., Zangrillo, A., & Landoni, G. (2020) · Journal of Cardiothoracic and Vascular Anesthesia · doi:10.1053/j.jvca.2020.09.117 · Cited by 299
Defining Pediatric Chronic Critical Illness: A Scoping Review*
Zorko, D. J., McNally, J. D., Rochwerg, B. N., Pinto, N. P., O’Hearn, K., Almazyad, M. A., Ames, S. G., Brooke, P., Cayouette, F., Chow, C., et al. (2022) · Pediatric Critical Care Medicine · doi:10.1097/pcc.0000000000003125 · Cited by 49
“The most common statistical method applied was a percentile LOS cut-off for their PICU population (n = 15), ranging from the 75th percentile (36) to 97th percentile (44), with variability in the resultant LOS threshold even when the same percentile was used.”
MethodHagel, J. A., Sperotto, F., Laussen, P. C., Salvin, J. W., Bachu, A., & Kheir, J. N. (2020) · Pediatric Critical Care Medicine · doi:10.1097/pcc.0000000000002524 · Cited by 15
“, the Vasoactive-Inotropic Score and the ventilation vasoactive renal score) are currently used as indirect measures of the magnitude of hemodynamic perturbation and were found to be independent predictors of adverse outcome in pediatric patients when measured within 24 hours after cardiac surgery (17, 18).”
BackgroundShukla, I., Hanson, S. J., Yan, K., & Zhang, J. (2021) · Frontiers in Pediatrics · doi:10.3389/fped.2021.769932 · Cited by 13
“When the VVR score was first developed and subsequently validated in acyanotic pediatric patients who underwent cardiac surgery with cardio-pulmonary bypass (8, 9), the renal score was calculated using the difference between post-operative creatinine and the baseline creatinine prior to surgery.”
MethodResultInfluentialBierer, J., Stanzel, R., Henderson, M., Sapp, J., Andreou, P., Marshall, J., & Horné, D. (2024) · European Journal of Medical Research · doi:10.1186/s40001-024-02156-0 · Cited by 6
“…throughout CPB or clustered with post-operative clinical variables in the PCA-HCPC were assessed with Spearman’s linear correlation between the End-CPB mediator concentration with ICU LOS and Peak VVR as two robust surrogates of critical care requirements and post-operative recovery [14, 22].”
Vasoactive-ventilation-renal score and outcomes in infants and children after cardiac surgery
Abhay, P., Sharma, R., Bhan, A., Raina, M., Vadhera, A., Akole, R., Mir, F. A., Bajpai, P., Misri, A., Srivastava, S., et al. (2023) · Frontiers in Pediatrics · doi:10.3389/fped.2023.1086626 · Cited by 5
“The STAT score has not been found to be significantly associated with PICU LOS postcardiac surgery, and studies on the same are limited.”
BackgroundMethodResultInfluentialThe effect of Vasoactive- ventilation- renal score on pediatric heart surgery
Öztürk, E. (2020) · Northern Clinics of Istanbul · doi:10.14744/nci.2020.77775 · Cited by 6
“Lately, a postoperatively calculated vasoactive-ventilation-renal (VVR) score was claimed to be used as a strong predictor [9, 10].”
BackgroundMethodResultInfluentialRivera, D. M. T., Garcia, R. U., & Aggarwal, S. A. (2020) · Cardiology in the Young · doi:10.1017/s1047951120004588 · Cited by 4
Cirstoveanu, C. G., Georgescu, C., Ruxandra, N., Bizubac, M., Cinteză, E. E., Vasile, C. M., Filip, C. I., & Margarint, I. M. (2023) · Pediatric Reports · doi:10.3390/pediatric15020028 · Cited by 5
“The VVR score proved more useful than the vasoactive-inotropic score (VIS) and lactate level in predicting clinical outcomes in the early postoperative period [10].”
BackgroundKaya, B., Akduman, H., Díllí, D., Ünsal, N., Fettah, N. D., & Zenciroğlu, A. (2024) · Diagnostics · doi:10.3390/diagnostics14242796 · Cited by 3
Nedelcu, C., Ionescu, N. S., Bizubac, A. M., Filip, C., & Cirstoveanu, C. (2025) · Life · doi:10.3390/life15101621 · Cited by 2
“The VVR score has shown utility in predicting postoperative outcomes and mortality in pediatric cardiac surgery patients [45].”
Kiran, K. S. R., Parikh, N., Venuthurupalli, R. S. P., Haranal, M. Y., Pandya, H., Kapoor, A., & Patel, K. P. (2024) · Journal of Anaesthesiology Clinical Pharmacology · doi:10.4103/joacp.joacp_210_23 · Cited by 1
“[9] The 48 hrs VVR measurements can help us assess the sustained severity of the illness in the postoperative period, which could likely influence the outcome than transient organ dysfunction in immediate postoperative period.”
BackgroundChauhan, S., Batra, P., Bhaskar, V., & Gupta, P. (2025) · Indian Pediatrics · doi:10.1007/s13312-025-00076-8 · Cited by 2
“Alam, et al. reported an AUC of 0.92 for the VVRS in predicting mortality 48-h after cardiac surgery in children [6].”
InfluentialYang, Z., Zhuo-min, X., Chen, L., Zhang, Y., Li, Y., Deng, H., Zhang, W., & Luo, W. (2024) · Congenital Heart Disease · doi:10.32604/chd.2025.057681 · Cited by 1
“The vasoactive drug score used in this study was VIS, proposed by Gaies et al. [21] in 2010, and the score was evaluated 24 h after surgery, except for children exposed to ECMO [22].”
Papadimos, T. J. (2018) · International Journal of Critical Illness and Injury Science · doi:10.4103/ijciis.ijciis_55_18
“[11] In this issue, Alam et al. presented us with a study that was large as compared to previous studies on the topic, the study examined research findings that are considered relatively established (multiple papers on the topic of VVR, VIS, and VI), and the statistics were well explained.”
ResultInfluentialBakhsh, M. A., Elbehery, M., Abdulaziz, J., Anbarserry, I., Al-Hindi, M. Y., & Aboremsh, H. A. (2024) · Research Square · doi:10.21203/rs.3.rs-3969367/v1
Bakhsh, M. A., Al-Hindi, M. Y., Abdulaziz, J., Elbehery, M., Anbarserry, I., & Aboremsh, H. A. (2024) · Saudi Critical Care Journal · doi:10.4103/sccj.sccj_6_24
Önemli, C. S., Şahin, K. E., Gülaştı, Ö. F., Karaçelik, M., & Bilen, Ç. (2024) · Meandros Medical And Dental Journal · doi:10.69601/meandrosmdj.1532632
Parikh, N., Rajesh, V. S. P., Kiran, K. S. R., Prajapati, D., Pujara, J., Surti, J., Srimallikarchunan, A., & Pandya, H. (2025) · The Indian Anaesthetists Forum · doi:10.4103/theiaforum.theiaforum_28_25
Metadata
- Authors
- Akunuri, S., Alam, S., Jain, A., Mazahir, R., & Hegde, R.
- Affiliations
- University Hospital of Wales (GB)
- Birmingham Children's Hospital (GB)
- Narayana Health (IN)
- Corresponding author
- Akunuri, Shalini
- Venue
- International Journal of Critical Illness and Injury Science
- Published
- 2018
- Volume
- 8
- Issue
- 3
- Pages
- 143
- ISSN
- 2229-5151 (ISSN-L)
- PMC
- PMC6116311
- OpenAlex
- W2889645752
- Cited by
- 20
- References
- 24
- Citations by year
- 2025: 3 · 2024: 7 · 2023: 2 · 2022: 1 · 2021: 2 · 2020: 4 · 2018: 1
- FWCI
- 1.37
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- cc-by-nc-sa
- Locations
- International Journal of Critical Illness and Injury Science (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-sa)
- PubMed Central (publishedVersion, cc-by-nc-sa)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Congenital Heart Disease Studies
- Health Sciences › Medicine › Surgery › Hemodynamic Monitoring and Therapy
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Sepsis Diagnosis and Treatment
- Keywords
- pediatric cardiac surgery, postoperative outcome prediction, ICU mortality, length of hospital stay, hemodynamic instability, renal function, postoperative complications, prognostic score
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