Inorganic phosphorus as a predictor of postoperative low cardiac output syndrome in congenital heart disease surgery.

Abstract

Background and objective: Low cardiac output syndrome (LCOS) is the most common complication after cardiac surgery in children with congenital heart disease (CHD). The aim of this study was to assess the predictive value of serum inorganic phosphorus (SIPL) as an indicator of LCOS in the postoperative period.

Materials and methods: From June 2018 to December 2019, a single-center prospective study was conducted in patients with CHD undergoing surgery who required extracorporeal circulation (ECC). In the postoperative period, patients were divided into group 1 with LCOS and group 2 without LCOS. Blood samples were extracted in pre and postoperative periods. Serial measurements of SIPL, NT-proBNP, troponin T and creatinine were collected and compared between both groups. Multivariate analyses were conducted to identify the risk factors of SBGC.

Results: A total of 97 patients were included, with 31 in group 1 and 66 in group 2. There was an increment of SIPL which peaked at the 8-h postsurgery (5.3 mg/dL, 4.6-5.8). Postoperative median SIPL in the group 1 were significantly higher than in the group 2. All consecutive SIPL measurements also were significantly higher in group 1. Changes in SIPL over time approached statistical significance (p < 0.001). Logistic regression analyses indicated that ECC (OR: 1.01; 95% CI: 0,9-1.01), SIPL (OR: 1.02; 95% CI: 1-1.04), NT-ProBNP (OR: 1; 95% CI; 1-1.0) were the independent risk factors of LCOS.

Conclusions: The increase in SIPL was more pronounced in LCOS group 1. SIPL emerged as a new predictive risk factors of LCOS.