title: Vasoactive Inotrope Score as a tool for clinical care in children post cardiac surgery.
abstract: BACKGROUND
  Neonates and infants undergoing heart surgery on cardiopulmonary bypass (CPB) are at high risk for significant post-operative morbidity and mortality. Hence, there is a need to identify and quantify clinical factors during the early post-operative period that are indicative of short-term as well as long-term outcomes. Multiple inotrope scores have been used in practice to quantify the amount of cardiovascular support received by neonates.
  
  
  OBJECTIVE
  The goal of this study was to determine the association between inotropic/vasoactive support and clinical outcomes in children after open cardiac surgery.
  
  
  METHODS
  This is a retrospective analysis of the 208 patients who underwent cardiac surgery for congenital heart disease at a tertiary pediatric cardiac surgery Intensive Care Unit (ICU) from January 2012 to March 2013. Multiple demographic, intra-operative and post-operative variables were recorded, including the Vasoactive Inotrope Score (VIS).
  
  
  RESULTS
  A total of 208 patients underwent cardiac surgery for congenital heart disease in the study period. The mean age and weight in the study were 66.94 months and 16.31 kg, respectively. Statistically significant associations were found in the various variables and VIS, including infancy, weight < 10 kg, CPB time, pump failure and post-operative variables like sepsis, hematological complications, hepatic dysfunction, acute kidney injury during admission, mortality, prolonged ventilator requirement, CPB time (in min) and hospital stay.
  
  
  CONCLUSIONS
  Inotrope score and its adaptations are an excellent tool to measure illness severity, deciding interventions and during parental counseling in the pediatric cardiac surgery ICUs.
authors.affiliation: Kidney Institute, Medanta, The Medicity Hospital, Gurgaon, Haryana, India.
authors.forename: Maneesh
authors.initials: M
authors.lastname: Kumar
authors.affiliation: Kidney Institute, Medanta, The Medicity Hospital, Gurgaon, Haryana, India.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Sharma
authors.affiliation: Cardiothoracic Surgery, Medanta, The Medicity Hospital, Gurgaon, Haryana, India.
authors.forename: Sidharth Kumar
authors.initials: SK
authors.lastname: Sethi
authors.affiliation: Kidney Institute, Medanta, The Medicity Hospital, Gurgaon, Haryana, India.
authors.forename: Subeeta
authors.initials: S
authors.lastname: Bazaz
authors.affiliation: Kidney Institute, Medanta, The Medicity Hospital, Gurgaon, Haryana, India.
authors.forename: Prerna
authors.initials: P
authors.lastname: Sharma
authors.affiliation: Kidney Institute, Medanta, The Medicity Hospital, Gurgaon, Haryana, India.
authors.forename: Anil
authors.initials: A
authors.lastname: Bhan
authors.affiliation: Cardiothoracic Surgery, Medanta, The Medicity Hospital, Gurgaon, Haryana, India.
authors.forename: Vijay
authors.initials: V
authors.lastname: Kher
keywords: Cardiac surgery; cardiopulmonary bypass; infants; inotropes