Abbas Qalab, Hussain Muhammad Zaid H, Shahbaz Fatima Farrukh, Siddiqui Naveed Ur Rehman, Hasan Babar S
Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
Medical College, Aga Khan University, Karachi, Pakistan.
Front Pediatr. 2022 Jun 3;10:846074. doi: 10.3389/fped.2022.846074. eCollection 2022.
To determine the performance of a commercially available risk analytic tool (IDO2) to estimate the risk for SVO2 < 40% in patients admitted in cardiac intensive care unit (CICU).
Medical and T3 records of all patients (aged 1 day to 12 years, weight >2 kg) who received care in the CICU between October 1st, 2019 and October 1st, 2020, had SvO2 lab(s) drawn during CICU course and whose data was transmitted to T3, were included. The average IDO2 Index was computed in the 30-min period immediately prior to each SvO2 measurement and used as a predictor score for SvO2 < 40%.
A total of 69 CICU admissions from 65 patients, median age 9.3 months (interquartile range 20.8) were identified. Surgical and medical patients were 61 (88%) and 8 (12%) respectively; 4 (5.7%) patients had single ventricle physiology. Tetralogy of Fallot = 23 (33.3%) and ventricular septal defects 17 (24.6%) were major cardiac diagnosis. Sixty-one (89.9%) of the admissions were successfully discharged from the hospital. Of the 187-total included SvO2 labs, 17 (9%) were <40%. The AUC of estimating SvO2 < 40% IDO2 was 0.87 [confidence interval (CI): 0.79-0.94]. Average IDO2 above 75 had the highest absolute risk (42.11, CI: 20.25-66.50) and highest RR (4.63, CI: 2.31-9.28, -value < 0.0001) of SvO2 < 40%.
IDO2 performed well in estimating low SvO2 (<40%) in pediatric patients presenting to a CICU in a low resource setting. Future work is needed to determine the effect of this risk analytic tool on clinical outcomes in such a setting.
确定一种市售风险分析工具（IDO2）在评估心脏重症监护病房（CICU）收治患者中SvO2＜40%风险方面的性能。
纳入2019年10月1日至2020年10月1日期间在CICU接受治疗、在CICU病程中进行了SvO2检测且数据已传输至T3的所有患者（年龄1天至12岁，体重＞2 kg）的医疗和T3记录。在每次SvO2测量前30分钟内计算平均IDO2指数，并将其用作SvO2＜40%的预测评分。
共确定了来自65例患者的69次CICU入院病例，中位年龄9.3个月（四分位间距20.8）。手术患者和内科患者分别为61例（88%）和8例（12%）；4例（5.7%）患者有单心室生理情况。主要心脏诊断为法洛四联症23例（33.3%）和室间隔缺损17例（24.6%）。61例（89.9%）入院患者成功出院。在总共187次纳入的SvO2检测中，17次（9%）＜40%。估计SvO2＜40%时IDO2的曲线下面积为0.87[置信区间（CI）：0.79 - 0.94]。IDO2高于75时，SvO2＜40%的绝对风险最高（42.11，CI：20.25 - 66.50），相对风险最高（4.63，CI：2.31 - 9.28，P值＜0.0001）。
在资源匮乏环境下就诊于CICU的儿科患者中，IDO2在估计低SvO2（＜40%）方面表现良好。需要开展进一步工作以确定这种风险分析工具在此类环境中对临床结局的影响。
