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1656 Biomarkers for Sepsis, Multiple Organ Dysfunction Syndrome (MODS) and Mortality after open Heart Surgery in Children
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  1. T da Rocha1,
  2. L Mulle2,
  3. C Ricachinevsky2,
  4. A Botta2,
  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 Aims Biomarkers can help to predict risk of unfavorable outcomes after open heart surgery in children.

Methods We performed a retrospective cohort of 121 children after open heart surgery. We analyzed the serum blood lactate, base excess (BE), blood glucose, central venous oxygen saturation (SATvc), troponin I, C-reactive protein (CRP), and leukocyte counts in different postoperative days (POd).

Results There were 7.4% deaths, 27.3% of sepsis and 60.3% of MODS. For death, showed better power PO1d and PO2d lactate (OR = 24.1 [CI 4–112]) and (OR = 9.7 [CI 1.2 to 85.7]); PO1d EB (OD = 30.6 [CI 2.6 to 351]); PO1d total leukocytes (OD = 5.8 (1.2 to 29.8]) For sepsis, showed better power: PO6h glucose (OD = 2.4 [1.03 to 5.7]); POI and PO3d SATvc (OD = 2.4 (1.09 to 5.8]) and (OD = 25 6 [2.2–298]); PO6h troponin I (OD = 2.8 [1.1 to 6.8]) and PO1d bastonades (OD = 6.5 [1.4 to 29.6 ]). For MODS, showed better power: PO6h and PO1d SATvc (OD = 12.2 [2.6 to 55.7]) (OD = 2.87 [1.1 to 7.4]) and, POI/PO6h/PO1d troponin-I (OD = 3.2 [1.6 to 8.0]); POI/PO6h CPR (OD = 3.7 [1.3 to 10.8]).

Conclusions Blood lactate, base excess, leukocyte count and percentage of bastonades are suitable markers of mortality. Blood glucose, central venous oxygen saturation and cardiac troponin-I are valued predictors of sepsis, and the last two were also reliable markers of MODS and CPR marker only the latter.

https://doi.org/10.1136/archdischild-2012-302724.1656

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