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The Utility of Albumin Level as a Marker of Postoperative Course in Infants Undergoing Repair of Congenital Heart Disease

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Abstract

We sought to examine the role of preoperative and 2nd postoperative day albumin levels as predictors for postoperative course in infants undergoing repair of congenital heart disease. This retrospective, single-center, observational study comprised consecutive infants younger than 1 year who had undergone repair of tetralogy of Fallot, ventricular septal defect, complete atrioventricular canal or transposition of the great arteries over a 25 months period. We correlated preoperative and postoperative day (POD) #2 albumin level to vaso-inotropic score (VIS) and intensive care unit (ICU) length of stay (LOS) as markers for degree and duration of postoperative cardiac support. A composite outcome was defined as maximal vaso-inotropic score of > 10 and ICU LOS > 96 h. Preoperative albumin level negatively correlated with VIS and ICU LOS. Compared to preoperative albumin level of > 4 g/dL, the relative risk of meeting composite criteria was 1.5 for preoperative albumin of 3.1–4 g/dL and 2.6 for preoperative albumin ≤ 3 g/dL. Compared to POD#2 albumin level > 3 g/dL, the relative risk of meeting composite criteria was 1.8 for albumin of 2.6–3 g/dL, and 2.5 for albumin ≤ 2.5 g/dL. In summary, we found that preoperative and POD#2 albumin levels predicted prolonged and complicated postoperative course. These finding may help clinicians to inform the patient’s parents, early in the ICU hospitalization, as to the predicted risks and difficulties of their infant’s postoperative course.

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Authors and Affiliations

  1. Pediatric Cardiac Intensive Care Unit, Schneider Children’s Medical Center of Israel, 14 Kaplan Street, 4920235, Petach Tikva, Israel

    Ofer Schiller, Sahar Mowassi, Eran Shostak, Orit Manor & Ovadia Dagan

  2. Division of Pediatric Hematology-Oncology, Schneider Children’s Medical Center of Israel, 49420235, Petach Tikva, Israel

    Oran Goldshmid

  3. Division of Pediatric Cardiothoracic Surgery, Schneider Children’s Medical Center of Israel, 49420235, Petach Tikva, Israel

    Gabriel Amir & Georgy Frenkel

  4. Sackler Faculty of Medicine, Tel Aviv University, 6997801, Tel Aviv, Israel

    Ofer Schiller, Gabriel Amir & Ovadia Dagan

Authors
  1. Ofer Schiller
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  2. Oran Goldshmid
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  3. Sahar Mowassi
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  4. Eran Shostak
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  6. Gabriel Amir
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Correspondence to Ofer Schiller.

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The authors declare that they have no conflicts of interest.

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This study was approved the local institutional review board. Parental/legal guardian informed consent was waived.

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Schiller, O., Goldshmid, O., Mowassi, S. et al. The Utility of Albumin Level as a Marker of Postoperative Course in Infants Undergoing Repair of Congenital Heart Disease. Pediatr Cardiol 41, 939–946 (2020). https://doi.org/10.1007/s00246-020-02339-6

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  • DOI: https://doi.org/10.1007/s00246-020-02339-6

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