Hostname: page-component-7c8c6479df-24hb2 Total loading time: 0 Render date: 2024-03-29T00:48:35.658Z Has data issue: false hasContentIssue false

Comparative risk of cardiac catheterisations performed on low birth weight neonates

Published online by Cambridge University Press:  07 February 2013

Meghan M. Mobley*
Affiliation:
Department of Pediatrics, Graduate Medical Education Office, Children's Mercy Hospital, Kansas City, Missouri, United States of America
Richard E. Stroup
Affiliation:
Department of Pediatric Cardiology & Cardiovascular Surgery, Children's Mercy Hospital, Kansas City, Missouri, United States of America
Stephen F. Kaine
Affiliation:
Department of Pediatric Cardiology, Children's Mercy Hospital, Kansas City, Missouri, United States of America
*
Correspondence to: Dr Meghan M. Mobley, MD, Department of Pediatrics, Graduate Medical Education Office, Children's Mercy Hospital, 2401 Gillham Road, Kansas City, Missouri 64108, United States of America. Tel: +1(816) 234-3371; Fax: +816-234-3701; E-mail: mmobley@cmh.edu

Abstract

To determine whether cardiac catheterisation procedures for low birth weight neonates ≤2.5 kg carries a greater risk of complications compared with neonates >2.5 kg, we conducted a single-centre retrospective case–control study. From 01/03 to 01/09, 46 consecutive neonates <2.5 kg at the time of cardiac catheterisation were identified. For each low birth weight case, three control patients >2.5 kg were randomly selected from our heart centre database during the same time period. Data included demographic characteristics, type of intervention, fluoroscopy time, contrast volume, pre- and post-blood urea nitrogen to creatinine ratio, physician performing procedure, procedural risk category, and all major and minor complications. The overall incidence of complications was higher in neonates ≤2.5 kg compared with neonates >2.5 kg (34.8% versus 17.6%, p = 0.023) because of a greater proportion of minor complications (34.8% versus 16.9%, p = 0.021). When specific minor complications were stratified, there was a greater incidence of hypotension requiring intravenous fluids in neonates ≤2.5 kg (6.5% versus 0%, p = 0.015). After controlling for physician performing procedure and risk category, neonates ≤2.5 kg remained at a higher risk for any complication (adjusted odds ratio = 3.2, 95% confidence interval 1.4–7.2, p = 0.005). The percentage of neonates having at least one major complication was not higher in the ≤2.5-kg group (2.2% versus 2.2%). No procedural deaths occurred in either group.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Cassidy, SC, Schmidt, KG, Van Hare, GF, Stanger, P, Teitel, DF. Complications of pediatric cardiac catheterization: a 3-year study. J Am Coll Cardiol 1992; 19: 12851293.CrossRefGoogle Scholar
2. Cohn, HE, Freed, MD, Hellenbrand, WF, Fyler, DC. Complications and mortality associated with cardiac catheterization in infants under one year: a prospective study. Pediatr Cardiol 1985; 6: 123131.CrossRefGoogle ScholarPubMed
3. McCrindle, BW. Independent predictors of long-term results after balloon pulmonary valvuloplasty. Circulation 1994; 89: 17511759.CrossRefGoogle ScholarPubMed
4. Mok, Q, Darvell, F, Mattos, S, et al. Survival after balloon atrial septostomy for complete transposition of great arteries. Arch Dis Child 1987; 62: 549553.CrossRefGoogle ScholarPubMed
5. Vitiello, R, McCrindle, BW, Nykanen, D, Freedom, RM, Benson, LN. Complications associated with pediatric cardiac catheterization. J Am Coll Cardiol 1998; 32: 14331440.CrossRefGoogle ScholarPubMed
6. Chen, MR, Hwang, HK, Yu, CH, Lin, YC. Cardiac catheterization in low birth weight infants. J Formos Med Assoc 2005; 104: 408411.Google ScholarPubMed
7. Kretschmar, O, Dahnert, I, Berger, F, Ewert, P, Lange, PE. Interventional treatment of congenital heart defects in infants with a body weight up to 2500 grams. Z Kardiol 2000; 89: 11261132.CrossRefGoogle ScholarPubMed
8. Simpson, JM, Moore, P, Teitel, DF. Cardiac catheterization of low birth weight infants. Am J Cardiol 2001; 87: 13721377.CrossRefGoogle ScholarPubMed
9. McMahon, CJ, Price, JF, Salerno, JC, et al. Cardiac catheterization in infants weighing less than 2500 grams. Cardiol Young 2003; 13: 117122.CrossRefGoogle ScholarPubMed
10. Sutton, N, Lock, JE, Geggel, RL. Cardiac catheterization in infants weighing less than 1,500 grams. Catheter Cardiovasc Interv 2006; 68: 948956.CrossRefGoogle Scholar
11. Bergersen, L, Gauvreau, K, Marshall, A, et al. Procedure-type risk categories for pediatric and congenital cardiac catheterization. Circ Cardiovasc Interv 2001; 4: 188194.CrossRefGoogle Scholar
12. Rhodes, JF, Asnes, JD, Blautox, AD, Sommer, RJ. Impact of low body weight on frequency of pediatric cardiac catheterization complications. Am J Cardiol 2000; 86: 12751278.CrossRefGoogle ScholarPubMed
13. Zeevi, B, Berant, M, Fogelman, R, Galit, BM, Blieden, LC. Acute complications in the current era of therapeutic cardiac catheterization for congenital heart disease. Cardiol Young 1999; 9: 266272.CrossRefGoogle ScholarPubMed
14. Martin, GR, Beekman, RH, Ing, FF, et al. The IMPACT registry: IMproving pediatric and adult congenital treatments. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2010; 13: 2025.CrossRefGoogle ScholarPubMed