12.11.2019 | Original Article | Ausgabe 1/2020 Open Access

Non-surgical Risk Factors for the Development of Chylothorax in Children after Cardiac Surgery-Does Fluid Matter?
- Zeitschrift:
- Pediatric Cardiology > Ausgabe 1/2020
Publisher's Note
Introduction
Materials and Methods
Study Design and Patient Population
Statistical Analysis
Results
Patient Demographics
Variable
|
Incidence
|
---|---|
Age (days), median (IQR)
|
189 (73.5, 1508.5)
|
Weight (kg), median (IQR)
|
6.56 (4.2, 15)
|
STAT score,
n (%)
|
|
1
|
140 (49)
|
2
|
63 (22)
|
3
|
31 (11)
|
4
|
44 (15)
|
5
|
5 (2)
|
RACHS-1 score,
n (%)
|
|
1
|
48 (17)
|
2
|
135 (47)
|
3
|
79 (28)
|
4
|
15 (5)
|
5
|
0 (0)
|
6
|
5 (2)
|
Sex,
n (%)
|
|
Male
|
148 (52)
|
Female
|
137 (48)
|
Surgeon 1,
n (%)
|
169 (59)
|
Surgeon 2,
n (%)
|
116 (41)
|
Bypass time (min), median (IQR)
|
69 (43, 97)
|
Cross clamp time (min), median (IQR)
|
36 (17, 62)
|
Re-operation,
n (%)
|
67 (23)
|
Any syndrome,
n (%)
|
64 (22)
|
Trisomy 21,
n (%)
|
29 (10)
|
Variable
|
Incidence
|
---|---|
Chylothorax,
n (%)
|
24 (8.4)
|
DVT, upper extremity,
n (%)
|
10 (3.5)
|
Maximum lactate (mmol/L), median (IQR)
|
2.2 (1.5, 3.5)
|
Time to initiation of feeds (h), median (IQR)
|
24.5 (9, 50)
|
Positive fluid balance at 24 h,
n (%)
|
191 (67)
|
> 10% Fluid overload in first 24 h,
n (%)
|
7 (2.5)
|
Positive fluid balance at 72 h,
n (%)
|
47 (17)
|
> 10% fluid overload in first 72 h,
n (%)
|
6 (2)
|
Fluid overload category in first 24 h,
n (%)
|
|
0 (< 0% fluid overload)
|
98 (34)
|
1 (0–10% fluid overload)
|
180 (63)
|
2 (> 10–20% fluid overload)
|
6 (2)
|
3 (> 20% fluid overload)
|
1 (0.4)
|
ECMO,
n (%)
|
6 (2)
|
Delayed sternal closure,
n (%)
|
22 (8)
|
Vasoactive infusion score, median (IQR)
|
8 (5, 12)
|
Vent free days, median (IQR)
|
28 (26, 28)
|
Presence of an arrhythmia,
n (%)
|
82 (29)
|
Reintubation,
n (%)
|
23 (8)
|
Central venous pressure 24 h, median (IQR)
|
10 (7, 12.5)
|
Central venous pressure 72 h, median (IQR)
|
10 (7, 13)
|
Acute kidney injury 24 h,
n (%)
|
154 (54)
|
KDIGO Stage 24 h,
n (%)
|
|
0
|
131 (46)
|
1
|
98 (34)
|
2
|
47 (16)
|
3
|
9 (3)
|
Acute kidney injury 72 h,
n (%)
|
56 (20)
|
Mortality,
n (%)
|
6 (2)
|
Univariate Analysis and Logistic Regression
Variable
|
Chylothorax (
n = 24)
|
No chylothorax (
n = 260)
|
p value
|
---|---|---|---|
Age (days), median (IQR)
|
115 (67, 183)
|
212 (74, 1628)
|
0.03
|
Weight (kg), median (IQR)
|
4.7 (4, 6)
|
6.7 (4, 17)
|
0.02
|
Bypass time (min), median (IQR)
|
93 (57, 131)
|
67 (42, 95)
|
0.03
|
Cross clamp time (min), median (IQR)
|
67 (21, 94)
|
34 (16, 57)
|
< 0.01
|
DVT, upper extremity
|
|||
Yes,
n (%)
|
7 (70.0)
|
3 (30.0)
|
< 0.01
|
No,
n (%)
|
17 (6.2)
|
258 (93.8)
|
|
Arrhythmia
|
|||
Yes,
n (%)
|
12 (14.6)
|
70 (85.4)
|
0.03
|
No,
n (%)
|
12 (5.9)
|
191 (94.1)
|
|
Acute kidney injury 24 h
|
|||
Yes,
n (%)
|
7 (4.6)
|
147 (95.4)
|
0.02
|
No,
n (%)
|
17 (13.0)
|
114 (87.0)
|
|
Trisomy 21
|
0.02
|
||
Yes,
n (%)
|
6 (20.7)
|
23 (79.3)
|
|
No,
n (%)
|
18 (7.0)
|
238 (93.0)
|
|
Positive fluid balance 24 h
|
0.65
|
||
Yes,
n (%)
|
15 (7.9)
|
176 (92.1)
|
|
No,
n (%)
|
9 (9.6)
|
85 (90.4)
|
|
> 10% fluid overload 24 h
|
0.46
|
||
Yes,
n (%)
|
1 (14.3)
|
6 (85.7)
|
|
No,
n (%)
|
23 (8.3)
|
255 (91.7)
|
|
Positive fluid balance 72 h
|
|||
Yes,
n (%)
|
6 (12.8)
|
41 (87.2)
|
0.25
|
No,
n (%)
|
18 (7.6)
|
220 (92.4)
|
|
> 10% fluid overload 72 h
|
|||
Yes,
n (%)
|
1 (16.7)
|
5 (83.3)
|
0.41
|
No,
n (%)
|
23 (8.2)
|
256 (91.8)
|
|
Time to feeds (h), median (IQR)
|
49 (25, 68)
|
24 (8, 48)
|
0.01
|
Central venous pressure 24 h (mmHg), median (IQR)
|
10 (5, 12)
|
10 (7, 13)
|
0.59
|
Central venous pressure 72 h (mmHg), median (IQR)
|
9 (5, 14)
|
10 (7, 13)
|
0.59
|
Variable
|
OR (95% CI)
|
p value
|
---|---|---|
DVT, upper extremity
|
31.24 (6.13, 159.28)
|
< 0.01
|
Trisomy 21
|
3.59 (1.15, 11.18)
|
0.04
|
Bypass time
|
0.99 (0.98, 1.01)
|
0.41
|
Cross clamp time
|
1.02 (0.99, 1.04)
|
0.16
|
Arrhythmia
|
1.38 (0.48, 3.98)
|
0.56
|
Age
|
1.00 (0.998, 1.001)
|
0.77
|
Weight
|
0.97 (0.79, 1.19)
|
0.77
|