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1657 Mortality in Post-Cardiac Surgery in Children: The role of Multiple Organ Dysfunction
  1. T da Rocha1,
  2. A Botta2,
  3. C Ricachinevsky2,
  4. LD Mulle2,
  5. P Carvalho1
  1. 1Uti Pediatrica Hospital Santo Antonio, Universidade Federal do Rio Grande do Sul
  2. 2Uti Pediatrica Hospital Santo Antonio, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil

Abstract

Background and Aim The multiple organ dyfunction syndrome (MODS) is associated to worse prognosis in critical setting. Its role after open heart surgery is still purely studied.

Methods We made a retrospective cohort of 121children to study factors associated to mortality after open heart surgery such as systemic inflammatory response syndrome (SIRS), MODS, sepsis, low cardiac output syndrome (LCOS), respiratory and cardiac support time.

Results 7.4% of non survivors occurred. The presence of sepsis in the first postoperative day had the highest odds ratio (OR) = 31.71(2.6 to 393.8), followed by renal dysfunction on the third day, OD=14.1 2.9 to 66.6); uni ventricular correction, OD=14.2 (2.9 to 66.66); the presence of MODS on the third day, OD=10.0 (1.9 to 50 9); presence of LCOS on the fifth day, OD=9.1 (2.1 to 40.2); and cardiac and respiratory dysfunction in the fifth day, OD=6 (1.4 to 25.6). On the other hand, the absence of SIRS in the immediate postoperative period was protective, with OD=0.92 (0.87 to 0.97). Furthermore, the mean time of cardiac support was higher in non survivors (98.8 vs. 53.7 hours), also respiratory support (42.2 h vs. 87 hours) and time of hypotension (85.2 h vs. 62.2 hours) than in survivors (p<0.05).

Conclusions The increased risk of mortality due to MODS appears to be caused by primary cardiac dysfunction, as there is also an association with LCOS, renal and respiratory dysfunctions secondary to the first.

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