naa a22 4500 510744362 CHVBK 20180411083040.0 cr unu---uuuuu 180411e20130501xx s 000 0 eng 10.1007/s12630-013-9907-9 doi (NATIONALLICENCE)springer-10.1007/s12630-013-9907-9 The effect of intraoperative hypotension on the outcomes of initial hybrid palliation for single ventricle congenital heart disease: an historical cohort study [Elektronische Daten] [James Koziol, Ralph Gertler, Cedric Manlhiot, Brian McCrindle, Helen Holtby, Christopher Caldarone, Katherine Taylor] Effet de l'hypotension peropératoire sur le pronostic d'une palliation hybride initiale pour les cardiopathies congénitales d'un seul ventricule: une étude de cohorte historique Background: The "hybrid procedure” is an alternative surgical palliation strategy for single ventricle congenital heart disease. The purported benefit is improved cognitive ability secondary to avoidance of cardiopulmonary bypass in the neonatal period when neuronal apoptosis is greater. It is unknown whether survival is improved after this procedure. Intraoperative hypotension is common in these patients, and we hypothesized that this hypotension was associated with mortality or morbidity. Methods: We reviewed the records of 58/58 patients undergoing a first-stage hybrid procedure from 2004 to 2010 in a tertiary pediatric academic centre. Risk factors for poor outcome and the association between intraoperative hypotension and morbidity or mortality were investigated. Results: Average preoperative arterial blood pressure (ABP) [systolic/diastolic presented as mean (standard deviation)] were 68 (12.7) / 38 (9.4) mmHg. Post-induction ABP was 65 (15.2) / 37 (8.6) mmHg. The average intraoperative nadir of ABP was 45 (7.0) / 26 (4.8) mmHg. On return to the intensive care unit (ICU), the average ABP was 69 (13.7) / 38 (11.6) mmHg. The nadir lasted longer than ten minutes in 32/58 patients. The mortality at 48 hr, 60days, and 12months was 3/58 (5%), 10/58 (17%), and 15/58 (26%), respectively. Six patients returned to the ICU on extracorporeal membrane oxygenation (ECMO). There was a weak statistical correlation between the average mean and diastolic BP pre-induction and changes of >20% in systolic and diastolic BP during the case. Conclusion: In this patient cohort, we can show an association between short periods of intraoperative hypotension and mortality or return to the ICU on ECMO, but the importance of this is not certain. Canadian Anesthesiologists' Society, 2013 Koziol James Department of Anesthesia and Pain Medicine, Hospital for Sick Children, Toronto, ON, Canada aut Gertler Ralph Institute of Anaesthesiology, German Heart Centre Munich, Munich, Germany aut Manlhiot Cedric Department of Cardiology, Labatt Family Heart Centre, Hospital for Sick Children, Toronto, ON, Canada aut McCrindle Brian Department of Cardiology, Labatt Family Heart Centre, Hospital for Sick Children, Toronto, ON, Canada aut Holtby Helen Department of Anesthesia and Pain Medicine, Hospital for Sick Children, Toronto, ON, Canada aut Caldarone Christopher Department of Cardiovascular Surgery, Hospital for Sick Children, Toronto, ON, Canada aut Taylor Katherine Department of Anesthesia and Pain Medicine, Hospital for Sick Children, Toronto, ON, Canada aut Canadian Journal of Anesthesia/Journal canadien d'anesthésie Springer-Verlag 60/5(2013-05-01), 465-470 0832-610X 60:5<465 2013 60 12630 https://doi.org/10.1007/s12630-013-9907-9 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12630-013-9907-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Koziol James Department of Anesthesia and Pain Medicine, Hospital for Sick Children, Toronto, ON, Canada aut NATIONALLICENCE 700 1- Gertler Ralph Institute of Anaesthesiology, German Heart Centre Munich, Munich, Germany aut NATIONALLICENCE 700 1- Manlhiot Cedric Department of Cardiology, Labatt Family Heart Centre, Hospital for Sick Children, Toronto, ON, Canada aut NATIONALLICENCE 700 1- McCrindle Brian Department of Cardiology, Labatt Family Heart Centre, Hospital for Sick Children, Toronto, ON, Canada aut NATIONALLICENCE 700 1- Holtby Helen Department of Anesthesia and Pain Medicine, Hospital for Sick Children, Toronto, ON, Canada aut NATIONALLICENCE 700 1- Caldarone Christopher Department of Cardiovascular Surgery, Hospital for Sick Children, Toronto, ON, Canada aut NATIONALLICENCE 700 1- Taylor Katherine Department of Anesthesia and Pain Medicine, Hospital for Sick Children, Toronto, ON, Canada aut NATIONALLICENCE 773 0- Canadian Journal of Anesthesia/Journal canadien d'anesthésie Springer-Verlag 60/5(2013-05-01), 465-470 0832-610X 60:5<465 2013 60 12630 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer