%0 Journal Article %1 Cheung2005 %A Cheung, Po-Yin %A Chui, Natalie %A Joffe, Ari R %A Rebeyka, Ivan M %A Robertson, Charlene M T %A Western Canadian Complex Pediatric Therapies Project, Follow-up Group %D 2005 %J J Thorac Cardiovasc Surg %K Biological Markers; Blindness; Cardiac Surgical Procedures; Cerebral Palsy; Child Development; Cohort Studies; Follow-Up Heart Defects, Congenital; Hospital Mortality; Humans; Infant; Infant, Newborn; Intensive Care Units, Pediatric; Lactic Acid; Mental Retardation; Postoperative Period; Prognosis; Sensitivity and Specificity; Survival Rate %N 3 %P 837--843 %T Postoperative lactate concentrations predict the outcome of infants aged 6 weeks or less after intracardiac surgery: a cohort follow-up to 18 months. %V 130 %X OBJECTIVES: An observational cohort study was conducted in infants less than 6 weeks of age undergoing intracardiac surgery to examine the predictive value of serial postoperative lactate determination on survival and early childhood neurodevelopment. METHODS: A total of 85 infants with congenital heart disease underwent intracardiac surgery between 1996 and 1999. Differences in serial lactate concentrations after surgery among 3 outcome groups were compared. The predictive value of plasma lactate concentration on outcome (1) at discharge from initial hospitalization and (2) 18 to 24 months postnatal age was examined. RESULTS: Compared with survivors, the nonsurvivors had higher lactate concentrations on admission to the pediatric intensive care unit at day 1 peak and area under the curve of the lactate profile than those of adverse and intact survivors (all P < .001, analysis of variance). Significant differences in the time for lactate concentrations to return to 2 mmol/L or less during the first postoperative day were observed among the groups: nonsurvivors > adverse survivors > intact survivors. Lactate concentrations of less than 7 mmol/L on admission or less than 8 mmol/L at day 1 peak predicted survival with 82\% sensitivity and 83\% specificity, and positive and negative predictive values of 97\% and 43\%, respectively (P < .001, chi2). Plasma lactate concentrations were associated with adverse outcome but had lower predictive values compared with that for nonsurvival. CONCLUSIONS: Serial lactate determination accurately predicts survival and may help differentiate survivors with adverse outcome from those with intact neurodevelopment in early childhood.

@article{Cheung2005, abstract = {OBJECTIVES: An observational cohort study was conducted in infants less than 6 weeks of age undergoing intracardiac surgery to examine the predictive value of serial postoperative lactate determination on survival and early childhood neurodevelopment. METHODS: A total of 85 infants with congenital heart disease underwent intracardiac surgery between 1996 and 1999. Differences in serial lactate concentrations after surgery among 3 outcome groups were compared. The predictive value of plasma lactate concentration on outcome (1) at discharge from initial hospitalization and (2) 18 to 24 months postnatal age was examined. RESULTS: Compared with survivors, the nonsurvivors had higher lactate concentrations on admission to the pediatric intensive care unit at day 1 peak and area under the curve of the lactate profile than those of adverse and intact survivors (all P < .001, analysis of variance). Significant differences in the time for lactate concentrations to return to 2 mmol/L or less during the first postoperative day were observed among the groups: nonsurvivors > adverse survivors > intact survivors. Lactate concentrations of less than 7 mmol/L on admission or less than 8 mmol/L at day 1 peak predicted survival with 82\% sensitivity and 83\% specificity, and positive and negative predictive values of 97\% and 43\%, respectively (P < .001, chi2). Plasma lactate concentrations were associated with adverse outcome but had lower predictive values compared with that for nonsurvival. CONCLUSIONS: Serial lactate determination accurately predicts survival and may help differentiate survivors with adverse outcome from those with intact neurodevelopment in early childhood.}, added-at = {2014-07-19T19:15:07.000+0200}, author = {Cheung, Po-Yin and Chui, Natalie and Joffe, Ari R and Rebeyka, Ivan M and Robertson, Charlene M T and Western Canadian Complex Pediatric Therapies Project, Follow-up Group}, biburl = {https://www.bibsonomy.org/bibtex/223570bd7ab75dc24b15207a93d328df7/ar0berts}, groups = {public}, interhash = {d65131042b738d0c88fe7574382cb27c}, intrahash = {23570bd7ab75dc24b15207a93d328df7}, journal = {J Thorac Cardiovasc Surg}, keywords = {Biological Markers; Blindness; Cardiac Surgical Procedures; Cerebral Palsy; Child Development; Cohort Studies; Follow-Up Heart Defects, Congenital; Hospital Mortality; Humans; Infant; Infant, Newborn; Intensive Care Units, Pediatric; Lactic Acid; Mental Retardation; Postoperative Period; Prognosis; Sensitivity and Specificity; Survival Rate}, month = Sep, number = 3, pages = {837--843}, pmid = {16153937}, timestamp = {2014-07-19T19:15:07.000+0200}, title = {Postoperative lactate concentrations predict the outcome of infants aged 6 weeks or less after intracardiac surgery: a cohort follow-up to 18 months.}, username = {ar0berts}, volume = 130, year = 2005 }