Influence of Intraoperative Fluid Balance on the Incidence of Adverse Events in Pediatric Cardiac Surgery

N/ACompletedNCT05142046

Brugmann University Hospital1,400 enrolled

Overview

The intraoperative fluid balance during pediatric cardiac surgery is a very sensitive parameter given the low circulating volume and the complexity of anesthetic management but might be deleterious if inadequately managed. The hypothesis is that a highly positive intraoperative fluid balance increases the incidence of adverse events in the short and long term. A retrospective observational study including all consecutive children admitted for cardiac surgery with cardiopulmonary bypass (CPB) from 2008 to 2018 in a tertiary children's hospital will be performed. A multivariate analysis will be carried out to study the effect of the fluid balance on the incidence of adverse events.

Study Type

OBSERVATIONAL

Enrollment

1,400

Conditions

Congenital Heart Disease in Children Surgery Fluid Overload

Interventions

Fluid balance

The intervention consists of classic and standardized anesthesia management of children undergoing cardiac surgery. All the data links to the fluid management will be extracted from the patient's chart in the intraoperative period as well as complications during the hospitalization in the postoperative period.

Eligibility

Sex: ALLMax age: 16 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Children aged 0-16 years and * Cardiac surgery with cardiopulmonary bypass and * operated between 2008 and 2018 at the Queen Fabiola University Children's Hospital (tertiary children's hospital) Exclusion Criteria: * ASA (American Society of Anesthesiologists) score of 5 * Jehovah's Witnesses * incomplete hospital record

Locations (1)

Hôpital Universitaire des Enfants Reine Fabiola

Brussels, Belgium

Outcomes

Primary Outcomes

Severe postoperative morbidity

Severe postoperative morbidity will be characterized as the presence of two or more of the following situations: respiratory failure, prolonged inotropic support, or renal failure. Respiratory failure will be defined as the requirement for mechanical ventilation for \>82 hours at any time from Pediatric Intensive Care Unit admission to the time of tracheal extubation. Prolonged inotropic support will be characterized as hemodynamic support by continuous vasoactive drug infusion for \>48 hours postoperatively (excluding dopamine or dobutamine ≤5 μg/kg/min). Renal failure will be characterized as the worst estimated postoperative creatinine clearance (eCCr) value showing a ≥75% reduction compared with the preoperative baseline eCCr.