Faculty Opinions recommendation of Vasoactive-inotropic score as a predictor of morbidity and mortality in infants after cardiopulmonary bypass.

Vasoactive and inotropic medications are essential for sepsis management; however, the association between the maximum Vasoactive-Inotropic score (VISmax) and clinical outcomes is unknown in adult patients with sepsis. We investigated the VISmax as a predictor for mortality among such patients in the emergency department (ED) and compared its prognostic value with that of the sequential organ failure assessment (SOFA) score. This single-center retrospective study included 910 patients diagnosed with sepsis between January 2016 and March 2020. We calculated the VISmax using the highest doses of vasopressors and inotropes administered during the first 6 h on ED admission and categorized it as 0–5, 6–15, 16–30, 31–45, and >45 points. The primary outcome was 30-day mortality. VISmax for 30-day mortality was significantly higher in non-survivors than in survivors. The mortality rates in the five VISmax groups were 17.2%, 20.8%, 33.3%, 54.6%, and 70.0%, respectively. The optimal cut-off value of VISmax to predict 30-day mortality was 31. VISmax had better prognostic value than the cardiovascular component of the SOFA score and initial lactate levels. VISmax was comparable to the APACHE II score in predicting 30-day mortality. Multivariable analysis showed that VISmax 16–30, 31–45, and >45 were independent risk factors for 30-day mortality. VISmax in ED could help clinicians to identify sepsis patients with poor prognosis.

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The relationship between vasoactive-inotropic score and mortality in the adult patients with traumatic brain injury managed in the intensive care unit

Turkish Neurosurgery ◽

10.5137/1019-5149.jtn.25177-18.1 ◽

2018 ◽

Author(s):

Iskender Kara ◽

Mehmet Sargin ◽

Yesim Serife Bayraktar ◽

Mert Sahinoglu ◽

Gurban Ildarov ◽

...

Keyword(s):

Intensive Care Unit ◽

Traumatic Brain Injury ◽

Intensive Care ◽

Brain Injury ◽

Adult Patients ◽

Inotropic Score ◽

Vasoactive Inotropic Score ◽

The Relationship

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Vasoactive-Inotropic Score: Evolution, Clinical Utility, and Pitfalls

Journal of Cardiothoracic and Vascular Anesthesia ◽

10.1053/j.jvca.2020.09.117 ◽

2020 ◽

Author(s):

Alessandro Belletti ◽

Caterina Cecilia Lerose ◽

Alberto Zangrillo ◽

Giovanni Landoni

Keyword(s):

Clinical Utility ◽

Inotropic Score ◽

Vasoactive Inotropic Score

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Risk factors for chylothorax and persistent serous effusions after congenital heart surgery

European Journal of Cardio-Thoracic Surgery ◽

10.1093/ejcts/ezz203 ◽

2019 ◽

Vol 56 (6) ◽

pp. 1162-1169 ◽

Cited By ~ 2

Author(s):

Anna Raatz ◽

Martin Schöber ◽

Robert Zant ◽

Robert Cesnjevar ◽

André Rüffer ◽

...

Keyword(s):

Risk Factors ◽

Heart Surgery ◽

Venous Pressure ◽

Congenital Heart Surgery ◽

Central Venous ◽

Aortic Cross Clamp Time ◽

Aortic Cross Clamp ◽

Assist Device ◽

Inotropic Score ◽

Vasoactive Inotropic Score

Abstract OBJECTIVES This study evaluated the various risk factors for chylothorax and persistent serous effusions (>7 days) after congenital heart surgery and developed equations to calculate the probability of their occurrence. METHODS We performed a retrospective review of different medical databases at the University Hospital of Erlangen between January 2014 and December 2016. Full model regression analysis was used to identify risk factors, and prediction algorithms were set up to calculate probabilities. Discriminative power of the models was checked with the help of C-statistics. RESULTS Of 745 operations on 667 patients, 68 chylothoraxes (9.1%) and 125 persistent pleural effusions (16.8%) were diagnosed. Lowest temperature [P = 0.043; odds ratio (OR) 0.899], trisomy 21 (P = 0.001; OR 5.548), a higher vasoactive inotropic score on the day of surgery (P = 0.001; OR 1.070) and use of an assist device (P = 0.001; OR 5.779) were significantly associated with chylothorax. Risk factors for persistent serous effusions were a given or possible involvement of the aortic arch during the operation (P = 0.000; OR 3.982 and 2.905), univentricular hearts (P = 0.019; OR 2.644), a higher number of previous heart operations (P = 0.014; OR 1.436), a higher vasoactive inotropic score 72 h after surgery (P = 0.019; OR 1.091), a higher central venous pressure directly after surgery (P = 0.046; OR 1.076) and an aortic cross-clamp time >86 min (P = 0.023; OR 2.223), as well as use of an assist device (P = 0.002; OR 10.281). The prediction models for both types of effusions proved to have excellent discriminative power. CONCLUSIONS Persistent serous effusion is associated with a higher vasoactive inotropic score 72 h after surgery, an aortic cross-clamp time >86 min and elevated central venous pressure directly after surgery, which, in combination, potentially indicate cardiac stress. The developed logistic algorithm helps to estimate future likelihood.

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