LAUSR

Sun and Yao, 1 in their retrospective analysis of 400 pediatric patients over 3 months undergoing first ‐ time cardiac surgery with cardiopulmonary bypass (CPB) in China, studied perioperative factors which were predictive of early postoperative adverse outcomes. The primary focus of the study was liberation from mechanical ventilation, with patients requiring mechanical ventilation for more than 24 h postoperatively defined as the prolonged mechanical ventilation (PMV) group. Twenty ‐ three percent (93/401 patients) experience PMV. The secondary focus of the study was a composite of mortality and morbidity (bleeding, re ‐ exploration, reoperation, open chest, ECMO use, etc.) outcomes. The study collected several perioperative hemodynamics ‐ related data. The data most predictive of a need for PMV was the vasoactive ‐ inotropic Score (VIS) at 48 h, followed by the operation duration. In other words, patients who had a continuing need for the inotropic requirement at 48 h after surgery were likely to need extended mechanical ventilatory support as compared to the patients that had been weaned off inotropes by that time (VIS 48 h: 7 (PMV) versus 0 (non ‐ PMV), p < 0.05). Using the ROC curves, a VIS cut ‐ off score of 5.5 at 48 h post ‐ op had a sensitivity of 68% and specificity of 83% for predicting a continued need for PMV. The PMV group tended to have more extended operations with more prolonged cardiopulmonary