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Outcomes of Children with Unoperated Congenital Heart Disease Admitted to PICU—A Single-Center Experience

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Indian Journal of Pediatrics Aims and scope Submit manuscript

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.

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On reasonable request.

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Acknowledgements

The authors acknowledge the contributions of Pediatric Cardiology team and Cardiothoracic Surgery team in the management of the children. The authors are thankful to PICU nurses and residents for their contribution to the management of children. 

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Authors and Affiliations

  1. Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India

    Kiran Kumar Banothu, Sheetal Agarwal, Jhuma Sankar, S. K. Kabra & Rakesh Lodha

  2. Department of Pediatrics, Armed Forces Medical College, Pune, Maharashtra, India

    Arvind Kumar

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  1. Kiran Kumar Banothu
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  3. Sheetal Agarwal
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Contributions

KKB was involved in screening of records, data collection, data analysis, and writing the manuscript; AK and SA were involved in screening of records and data collection, and provided inputs to the manuscript; JS was involved in data analysis and provided critical inputs to the manuscript; SKK and RL supervised the study process and data analysis, and provided critical inputs to the paper and finalized the manuscript. RL will act as the guarantor for this paper.

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Correspondence to Rakesh Lodha.

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Banothu, K.K., Kumar, A., Agarwal, S. et al. Outcomes of Children with Unoperated Congenital Heart Disease Admitted to PICU—A Single-Center Experience. Indian J Pediatr 89, 1073–1078 (2022). https://doi.org/10.1007/s12098-022-04083-6

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  • DOI: https://doi.org/10.1007/s12098-022-04083-6

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