Dados do Trabalho

Título

Therapy guided by continuous venous saturation in pediatric cardiac surgery: PediaSat randomized trial

Objetivo

The primary objective of this study is to evaluate the effectiveness of a goal-directed hemodynamic optimization protocol based on continuous central venous oxygen saturation (SvcO2) in pediatric cardiac surgery. Secondary objectives include assessing the impact on postoperative outcomes such as lactate clearance, mechanical ventilation duration, vasopressor use, and ICU/hospital stay lengths.

Métodos

This randomized controlled trial involved pediatric patients undergoing cardiac surgery with cardiopulmonary bypass. Participants were divided into a control group receiving standard care and an intervention group guided by continuous SvcO2 monitoring. Primary outcome was 24-hour lactate clearance, with secondary outcomes including mechanical ventilation duration, vasopressor use, and ICU/hospital stay lengths.

Resultados

Among the 65 enrolled patients from July 2014 to March 2016, lactate clearance did not significantly differ between the intervention and control groups. However, the intervention group showed shorter mechanical ventilation times, reduced vasopressor use, and shorter ICU stays. The intervention group also received more fluids, with no differences in dobutamine use or blood transfusions.

Conclusão

While optimizing SvcO2 did not affect lactate clearance, it was associated with shorter mechanical ventilation duration, decreased vasopressor need, and reduced ICU stays in pediatric cardiac surgery patients, highlighting its potential benefits in postoperative care.