Factors associated with the need for inotropic support following pulmonary artery banding surgery for CHD

dc.contributor.authorMastropietro, Christopher W.
dc.contributor.authorClark, Andrea B.
dc.contributor.authorLoke, Katie L.
dc.contributor.authorChaudhry, Paulomi
dc.contributor.authorCossu, Annelisa E.
dc.contributor.authorPatel, Jyoti K.
dc.contributor.authorHerrmann, Jeremy L.
dc.contributor.departmentPediatrics, School of Medicine
dc.date.accessioned2025-01-10T19:43:01Z
dc.date.available2025-01-10T19:43:01Z
dc.date.issued2023-11
dc.description.abstractObjective: We aimed to identify factors independently associated with the need for inotropic support for low cardiac output or haemodynamic instability after pulmonary artery banding surgery for CHD. Methods: We performed a retrospective chart review of all neonates and infants who underwent pulmonary banding between January 2016 and June 2019 at our institution. Bivariate and multivariable analyses were performed to identify factors independently associated with the use of post-operative inotropic support, defined as the initiation of inotropic infusion(s) for depressed myocardial function, hypotension, or compromised perfusion within 24 hours of pulmonary artery banding. Results: We reviewed 61 patients. Median age at surgery was 10 days (25%,75%:7,30). Cardiac anatomy was biventricular in 38 patients (62%), hypoplastic right ventricle in 14 patients (23%), and hypoplastic left ventricle in 9 patients (15%). Inotropic support was implemented in 30 patients (49%). Baseline characteristics of patients who received inotropic support, including ventricular anatomy and pre-operative ventricular function, were not statistically different from the rest of the cohort. Patients who received inotropic support, however, were exposed to larger cumulative doses of ketamine intraoperatively – median 4.0 mg/kg (25%,75%:2.8,5.9) versus 1.8 mg/kg (25%,75%:0.9,4.5), p < 0.001. In a multivariable model, cumulative ketamine dose greater than 2.5mg/kg was associated with post-operative inotropic support (odds ratio 5.5; 95% confidence interval: 1.7,17.8), independent of total surgery time. Conclusions: Inotropic support was administered in approximately half of patients who underwent pulmonary artery banding and more commonly occurred in patients who received higher cumulative doses of ketamine intraoperatively, independent of the duration of surgery.
dc.eprint.versionAuthor's manuscript
dc.identifier.citationMastropietro, C. W., Clark, A. B., Loke, K. L., Chaudhry, P., Cossu, A. E., Patel, J. K., & Herrmann, J. L. (2023). Factors associated with the need for inotropic support following pulmonary artery banding surgery for CHD. Cardiology in the Young, 33(11), 2350–2356. https://doi.org/10.1017/S1047951123000203
dc.identifier.urihttps://hdl.handle.net/1805/45250
dc.language.isoen
dc.publisherTaylor & Francis
dc.relation.isversionof10.1017/S1047951123000203
dc.relation.journalCardiology in the Young
dc.rightsPublisher Policy
dc.sourceAuthor
dc.subjectcardiac surgical procedures
dc.subjectcongenital heart defects
dc.subjectketamine
dc.titleFactors associated with the need for inotropic support following pulmonary artery banding surgery for CHD
dc.typeArticle
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