Critical heart disease in the neonate: Presentation and outcome at a tertiary care center

• DOI: 10.1097/pcc.0b013e318166eda5
• Publication Date: 2008-03-04T08:01:10Z
• Authors: Aaron T. Dorfman; Bradley S. Marino; Gil Wernovsky; Sarah Tabbutt; Chitra Ravishankar; Rodolfo I. Godinez; Margaret Priestley; Kathryn M. Dodds; Jack Rychik; Peter J. Gruber; J William Gaynor; Richard J. Levy; Susan C. Nicolson; Lisa M. Montenegro; Thomas L. Spray; Troy E. Dominguez
• Keywords: Tertiary care; Center (category theory); Presentation (obstetrics)

Objective: To define the modes of presentation, incidence major organ dysfunction, predictors hospital mortality, and adverse outcomes in neonates with critical heart disease admitted to a tertiary care center. Design: Retrospective chart review. Setting: A pediatric cardiac intensive unit neonatal unit. Patients: The medical records for all (≤30 days age) or between October 1, 2002, September 30, 2003, were reviewed. Interventions: None. Measurements Main Results: total 190 met inclusion criteria during this 1-yr period, which 146 (77%) had at least one surgical procedure. Single ventricle was present 42%. most common mode presentation following prenatal diagnosis (53%), followed by newborn nursery (38%) after discharge (8%). presenting findings isolated murmur cyanosis (32%), while circulatory collapse discharge. For entire study cohort, 13% known genetic syndrome, 23% noncardiac congenital anomaly, 16% weighed <2.5 kg. mortality cohort 7.4%. Risk factors associated an increased risk included younger age admission, higher number cardiopulmonary bypass runs, need postoperative resuscitation. Total length stay >1 month 17% neonates. Conclusions: In patients complex disease, including nearly half single 7%. These have high frequency multiple anomalies, syndromes, low birth weight, prolonged stay.