Kiran Kumar Banothu1, Arvind Kumar2, Sheetal Agarwal1, Jhuma Sankar1, S K Kabra1, Rakesh Lodha3. 1. Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India. 2. Department of Pediatrics, Armed Forces Medical College, Pune, Maharashtra, India. 3. Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India. rlodha1661@gmail.com.
Abstract
OBJECTIVES: To evaluate the outcomes of children with congenital heart disease (CHD) awaiting surgery admitted to a pediatric intensive care unit (PICU) with acute illness. METHODS: In this retrospective study from a single center, the outcomes of children up to 18 y of age with unoperated CHD admitted to PICU with acute illness and factors affecting the outcomes, were evaluated. RESULTS: Fifty-eight (41 boys) children were included. Median age was 3.2 (1.5, 6) mo. Thirty-six (62%) children had acyanotic CHD (ACHD), and 22 (38%) had cyanotic CHD (CCHD). Most common ACHD was ventricular septal defect (n = 14; 38.8%) and CCHD was double-outlet right ventricle (n = 6; 27.2%). Twenty-four (41%) children underwent surgery - 10 (41.6%) palliative procedure and 14 (58.3%) corrective procedure. Hospital mortality was 50%. Of the operated children, 37.5% died and of the nonoperated children, 58.8% died. Type of the heart disease and surgical intervention was not associated with mortality (p = 0.27 and 0.11). Requirement of vasoactive agents was associated with increased mortality (p = 0.02). In children with ACHD, factors associated with mortality were lower score for weight for age (p = 0.03) and weight for length (p = 0.04), lower admission pH (p = 0.02), hemodynamic instability at admission (p = 0.002), and requirement of vasoactive agents (p = 0.04). CONCLUSION: Children with unoperated CHD with acute illness have high morbidity and mortality. Early diagnosis and surgical interventions in children with CHD are warranted. TRIAL REGISTRATION: Trial Registration No. IECPG-571/21.10.2020.
OBJECTIVES: To evaluate the outcomes of children with congenital heart disease (CHD) awaiting surgery admitted to a pediatric intensive care unit (PICU) with acute illness. METHODS: In this retrospective study from a single center, the outcomes of children up to 18 y of age with unoperated CHD admitted to PICU with acute illness and factors affecting the outcomes, were evaluated. RESULTS: Fifty-eight (41 boys) children were included. Median age was 3.2 (1.5, 6) mo. Thirty-six (62%) children had acyanotic CHD (ACHD), and 22 (38%) had cyanotic CHD (CCHD). Most common ACHD was ventricular septal defect (n = 14; 38.8%) and CCHD was double-outlet right ventricle (n = 6; 27.2%). Twenty-four (41%) children underwent surgery - 10 (41.6%) palliative procedure and 14 (58.3%) corrective procedure. Hospital mortality was 50%. Of the operated children, 37.5% died and of the nonoperated children, 58.8% died. Type of the heart disease and surgical intervention was not associated with mortality (p = 0.27 and 0.11). Requirement of vasoactive agents was associated with increased mortality (p = 0.02). In children with ACHD, factors associated with mortality were lower score for weight for age (p = 0.03) and weight for length (p = 0.04), lower admission pH (p = 0.02), hemodynamic instability at admission (p = 0.002), and requirement of vasoactive agents (p = 0.04). CONCLUSION: Children with unoperated CHD with acute illness have high morbidity and mortality. Early diagnosis and surgical interventions in children with CHD are warranted. TRIAL REGISTRATION: Trial Registration No. IECPG-571/21.10.2020.