Abstract

Objective

The correct use of cardiopulmonary bypass (CPB) during surgical treatment of congenital heart diseases is very important. With the new parameters monitored during CPB, the near-infrared spectroscopy (NIRS) device and the correct analysis of the blood gases, it is very likely to have an idea about the patient’s condition in the postoperative period. Our aim in this study is to find out whether the NIRS, lactate and hematocrit levels monitored and recorded at certain periods during CPB will have an effect on postoperative pediatric mortality scores.

Materials and Methods

107 patients were included in the study (n=107).  NIRS, lactate and hematocrit values were recorded before CPB, at the 5th minute, at the 30th minute and just before CPB termination. Postoperative day 1 Pediatric Risk of Mortality (PRISM) and Pediatric Index of Mortality 2 (PIM2) scores of the patients included in the study were calculated. The data we obtained were evaluated statistically.

Results

A 5% decrease in NIRS, lactate and hematocrit values did not affect Pediatric Mortality Scores (p>0.05), but when a 10% decrease was considered, it was seen that lactate and hematocrit did not affect pediatric mortality scores (p>0.05); it was found that PIM2 and PRISM scores of patients whose NIRS values decreased by 10% compared to the baseline value increased significantly (p<0.05).

Conclusion

The PRISM, PIM2 and RACHS-1 scoring systems that we applied to the patients determined that a 5% decrease in the NIRS values of the patients within a certain period did not have a significant effect on mortality. However, a 10% decrease in the NIRS values compared to the baseline value was found to have a significant effect on mortality according to the scoring systems we applied. However, it was concluded that a 5% and 10% decrease in the values recorded for certain periods of lactate and hematocrit levels did not have a significant effect on mortality according to the scoring systems we applied.