Standardized Treatment andDiagnostic Approach to Reduce Disease burden in the early postoperative phase in children with congenital heart defects—STANDARD study: a pilot randomized controlled trial
To explore the effect of a daily goal checklist on pediatric cardiac intensive care unit (PCICU) length of stay (LOS) after congenital heart surgery. This study is a prospective randomized single-center study. Group characteristics were as follows: STANDARD group: n = 30, 36.7% female, median age 0...
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| Veröffentlicht in: | European journal of pediatrics 2023-12, Vol.182 (12), p.5325-5340 |
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| creator | Vogt, Antonia Meyer, Sascha Schäfers, Hans-Joachim Weise, Julius Johannes Wagenpfeil, Stefan Abdul-Khaliq, Hashim Poryo, Martin |
| description | To explore the effect of a daily goal checklist on pediatric cardiac intensive care unit (PCICU) length of stay (LOS) after congenital heart surgery. This study is a prospective randomized single-center study. Group characteristics were as follows: STANDARD group:
n
= 30, 36.7% female, median age 0.9 years; control group:
n
= 33, 36.4% female, median age 1.1 years. Invasive ventilation time, STAT categories, mean vasoactive-inotropic score (VIS)
24h
, maximal (max.) VIS
24h
, mean VIS
24–48h
, max. VIS
24–48h
, VIS category, number of sedatives, analgesics, diuretics, number of deployed diagnostic modalities, morbidities, and mortality did not differ between both groups. Median PCICU LOS was 96.0 h (STANDARD group) versus 101.5 h (control group) (
p
= 0.63). In the overall cohort, univariate regression analysis identified age at surgery (
b
= −0.02), STAT category (
b
= 18.3), severity of CHD (
b
= 40.6), mean VIS
24h
(
b
= 3.5), max. VIS
24h
(
b
= 2.2), mean VIS
24–48h
(
b
= 6.5), and VIS category (
b
= 13.8) as significant parameters for prolonged PCICU LOS. In multivariate regression analysis, age at surgery (
b
= −0.2), severity of CHD (
b
= 44.0), and mean VIS
24h
(
b
= 6.7) were of significance. Within the STANDARD sub-group, univariate regression analysis determined STAT category (
b
= 32.3), severity of CHD (
b
= 70.0), mean VIS
24h
(
b
= 5.0), mean VIS
24–48h
(
b
= 5.9), number of defined goals (
b
= 2.6), number of achieved goals (
b
= 3.3), number of not achieved goals (
b
= 10.8), and number of unevaluated goals (
b
= 7.0) as significant parameters for prolonged PCICU LOS. Multivariate regression analysis identified the number of defined goals (
b
= 2.5) and the number of unevaluated goals (
b
= −3.0) to be significant parameters.
Conclusion
: The structured realization and recording of daily goals is of advantage in patients following pediatric cardiac surgery by reducing PCICU LOS.
What is known:
• Communication errors are the most frequent reasons for adverse events in intensive care unit patients.
• Improved communication can be achieved by discussion and documentation of the patients’ goals during daily rounds.
What is new:
• In the overall cohort age at surgery, severity of congenital heart defect and mean vasoactive inotropic score within the first 24 hours had significant impact on pediatric cardiac intensive care unit (PCICU) length of stay (LOS).
• In the intervention group, the number of defined goals and the |
| doi_str_mv | 10.1007/s00431-023-05191-x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_sprin</sourceid><recordid>TN_cdi_proquest_journals_2904771801</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2904771801</sourcerecordid><originalsourceid>FETCH-LOGICAL-p157t-67338a30ee6005be661082667ed8b36f80042b9311e73260137159f6dd7f50a13</originalsourceid><addsrcrecordid>eNpFkc1u1DAQxy0EEkvhBTiNxDkwE2_shNuqy5dUgdQu58gbTxpXaRxsp7Q99SF4J96DJ8HbReI0o9HvP19_IV4TviVE_S4iriUVWMoCK2qouH0iVrSWZUGo1VOxQrnGQlHTPBcvYrzCLGqoXonfF8lM1gTr7tnCLrBJ1zwlyMWtM5eTj8l1sJnn4E03QPJwznbpGLYusokM-yVYnsBNkAYGNmG8gzmr_MzBJHfDMA8HLgPd4EYbMvzTpQE6P13y5JIZYciyBJZ77lL88_DrYrf5ut2cbyGmxd69BwOzG32CkLfy14-bZnUKfhxzmoIz40vxrDdj5Ff_4on4_vHD7vRzcfbt05fTzVkxU6VTobSUtZHIrBCrPStFWJdKabb1Xqq-zn8s940kYi1LhSQ1VU2vrNV9hYbkiXhz7Jsf8mPhmNorv4Qpj2zLBtdaU40HSh6pOAeXzwz_KcL24Fh7dKzNjrWPjrW38i8r_Y3j</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2904771801</pqid></control><display><type>article</type><title>Standardized Treatment andDiagnostic Approach to Reduce Disease burden in the early postoperative phase in children with congenital heart defects—STANDARD study: a pilot randomized controlled trial</title><source>SpringerNature Journals</source><creator>Vogt, Antonia ; Meyer, Sascha ; Schäfers, Hans-Joachim ; Weise, Julius Johannes ; Wagenpfeil, Stefan ; Abdul-Khaliq, Hashim ; Poryo, Martin</creator><creatorcontrib>Vogt, Antonia ; Meyer, Sascha ; Schäfers, Hans-Joachim ; Weise, Julius Johannes ; Wagenpfeil, Stefan ; Abdul-Khaliq, Hashim ; Poryo, Martin</creatorcontrib><description>To explore the effect of a daily goal checklist on pediatric cardiac intensive care unit (PCICU) length of stay (LOS) after congenital heart surgery. This study is a prospective randomized single-center study. Group characteristics were as follows: STANDARD group:
n
= 30, 36.7% female, median age 0.9 years; control group:
n
= 33, 36.4% female, median age 1.1 years. Invasive ventilation time, STAT categories, mean vasoactive-inotropic score (VIS)
24h
, maximal (max.) VIS
24h
, mean VIS
24–48h
, max. VIS
24–48h
, VIS category, number of sedatives, analgesics, diuretics, number of deployed diagnostic modalities, morbidities, and mortality did not differ between both groups. Median PCICU LOS was 96.0 h (STANDARD group) versus 101.5 h (control group) (
p
= 0.63). In the overall cohort, univariate regression analysis identified age at surgery (
b
= −0.02), STAT category (
b
= 18.3), severity of CHD (
b
= 40.6), mean VIS
24h
(
b
= 3.5), max. VIS
24h
(
b
= 2.2), mean VIS
24–48h
(
b
= 6.5), and VIS category (
b
= 13.8) as significant parameters for prolonged PCICU LOS. In multivariate regression analysis, age at surgery (
b
= −0.2), severity of CHD (
b
= 44.0), and mean VIS
24h
(
b
= 6.7) were of significance. Within the STANDARD sub-group, univariate regression analysis determined STAT category (
b
= 32.3), severity of CHD (
b
= 70.0), mean VIS
24h
(
b
= 5.0), mean VIS
24–48h
(
b
= 5.9), number of defined goals (
b
= 2.6), number of achieved goals (
b
= 3.3), number of not achieved goals (
b
= 10.8), and number of unevaluated goals (
b
= 7.0) as significant parameters for prolonged PCICU LOS. Multivariate regression analysis identified the number of defined goals (
b
= 2.5) and the number of unevaluated goals (
b
= −3.0) to be significant parameters.
Conclusion
: The structured realization and recording of daily goals is of advantage in patients following pediatric cardiac surgery by reducing PCICU LOS.
What is known:
• Communication errors are the most frequent reasons for adverse events in intensive care unit patients.
• Improved communication can be achieved by discussion and documentation of the patients’ goals during daily rounds.
What is new:
• In the overall cohort age at surgery, severity of congenital heart defect and mean vasoactive inotropic score within the first 24 hours had significant impact on pediatric cardiac intensive care unit (PCICU) length of stay (LOS).
• In the intervention group, the number of defined goals and the number of unevaluated goals were significant parameters for prolonged PCICU LOS.</description><identifier>ISSN: 0340-6199</identifier><identifier>EISSN: 1432-1076</identifier><identifier>DOI: 10.1007/s00431-023-05191-x</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Age ; Analgesics ; Diuretics ; Heart surgery ; Intensive care ; Length of stay ; Medicine ; Medicine & Public Health ; Patients ; Pediatrics ; Regression analysis ; Sedatives ; Surgery ; Vasoactive agents</subject><ispartof>European journal of pediatrics, 2023-12, Vol.182 (12), p.5325-5340</ispartof><rights>The Author(s) 2023</rights><rights>The Author(s) 2023. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-p157t-67338a30ee6005be661082667ed8b36f80042b9311e73260137159f6dd7f50a13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00431-023-05191-x$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00431-023-05191-x$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids></links><search><creatorcontrib>Vogt, Antonia</creatorcontrib><creatorcontrib>Meyer, Sascha</creatorcontrib><creatorcontrib>Schäfers, Hans-Joachim</creatorcontrib><creatorcontrib>Weise, Julius Johannes</creatorcontrib><creatorcontrib>Wagenpfeil, Stefan</creatorcontrib><creatorcontrib>Abdul-Khaliq, Hashim</creatorcontrib><creatorcontrib>Poryo, Martin</creatorcontrib><title>Standardized Treatment andDiagnostic Approach to Reduce Disease burden in the early postoperative phase in children with congenital heart defects—STANDARD study: a pilot randomized controlled trial</title><title>European journal of pediatrics</title><addtitle>Eur J Pediatr</addtitle><description>To explore the effect of a daily goal checklist on pediatric cardiac intensive care unit (PCICU) length of stay (LOS) after congenital heart surgery. This study is a prospective randomized single-center study. Group characteristics were as follows: STANDARD group:
n
= 30, 36.7% female, median age 0.9 years; control group:
n
= 33, 36.4% female, median age 1.1 years. Invasive ventilation time, STAT categories, mean vasoactive-inotropic score (VIS)
24h
, maximal (max.) VIS
24h
, mean VIS
24–48h
, max. VIS
24–48h
, VIS category, number of sedatives, analgesics, diuretics, number of deployed diagnostic modalities, morbidities, and mortality did not differ between both groups. Median PCICU LOS was 96.0 h (STANDARD group) versus 101.5 h (control group) (
p
= 0.63). In the overall cohort, univariate regression analysis identified age at surgery (
b
= −0.02), STAT category (
b
= 18.3), severity of CHD (
b
= 40.6), mean VIS
24h
(
b
= 3.5), max. VIS
24h
(
b
= 2.2), mean VIS
24–48h
(
b
= 6.5), and VIS category (
b
= 13.8) as significant parameters for prolonged PCICU LOS. In multivariate regression analysis, age at surgery (
b
= −0.2), severity of CHD (
b
= 44.0), and mean VIS
24h
(
b
= 6.7) were of significance. Within the STANDARD sub-group, univariate regression analysis determined STAT category (
b
= 32.3), severity of CHD (
b
= 70.0), mean VIS
24h
(
b
= 5.0), mean VIS
24–48h
(
b
= 5.9), number of defined goals (
b
= 2.6), number of achieved goals (
b
= 3.3), number of not achieved goals (
b
= 10.8), and number of unevaluated goals (
b
= 7.0) as significant parameters for prolonged PCICU LOS. Multivariate regression analysis identified the number of defined goals (
b
= 2.5) and the number of unevaluated goals (
b
= −3.0) to be significant parameters.
Conclusion
: The structured realization and recording of daily goals is of advantage in patients following pediatric cardiac surgery by reducing PCICU LOS.
What is known:
• Communication errors are the most frequent reasons for adverse events in intensive care unit patients.
• Improved communication can be achieved by discussion and documentation of the patients’ goals during daily rounds.
What is new:
• In the overall cohort age at surgery, severity of congenital heart defect and mean vasoactive inotropic score within the first 24 hours had significant impact on pediatric cardiac intensive care unit (PCICU) length of stay (LOS).
• In the intervention group, the number of defined goals and the number of unevaluated goals were significant parameters for prolonged PCICU LOS.</description><subject>Age</subject><subject>Analgesics</subject><subject>Diuretics</subject><subject>Heart surgery</subject><subject>Intensive care</subject><subject>Length of stay</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Regression analysis</subject><subject>Sedatives</subject><subject>Surgery</subject><subject>Vasoactive agents</subject><issn>0340-6199</issn><issn>1432-1076</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNpFkc1u1DAQxy0EEkvhBTiNxDkwE2_shNuqy5dUgdQu58gbTxpXaRxsp7Q99SF4J96DJ8HbReI0o9HvP19_IV4TviVE_S4iriUVWMoCK2qouH0iVrSWZUGo1VOxQrnGQlHTPBcvYrzCLGqoXonfF8lM1gTr7tnCLrBJ1zwlyMWtM5eTj8l1sJnn4E03QPJwznbpGLYusokM-yVYnsBNkAYGNmG8gzmr_MzBJHfDMA8HLgPd4EYbMvzTpQE6P13y5JIZYciyBJZ77lL88_DrYrf5ut2cbyGmxd69BwOzG32CkLfy14-bZnUKfhxzmoIz40vxrDdj5Ff_4on4_vHD7vRzcfbt05fTzVkxU6VTobSUtZHIrBCrPStFWJdKabb1Xqq-zn8s940kYi1LhSQ1VU2vrNV9hYbkiXhz7Jsf8mPhmNorv4Qpj2zLBtdaU40HSh6pOAeXzwz_KcL24Fh7dKzNjrWPjrW38i8r_Y3j</recordid><startdate>20231201</startdate><enddate>20231201</enddate><creator>Vogt, Antonia</creator><creator>Meyer, Sascha</creator><creator>Schäfers, Hans-Joachim</creator><creator>Weise, Julius Johannes</creator><creator>Wagenpfeil, Stefan</creator><creator>Abdul-Khaliq, Hashim</creator><creator>Poryo, Martin</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>3V.</scope><scope>7RV</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope></search><sort><creationdate>20231201</creationdate><title>Standardized Treatment andDiagnostic Approach to Reduce Disease burden in the early postoperative phase in children with congenital heart defects—STANDARD study: a pilot randomized controlled trial</title><author>Vogt, Antonia ; Meyer, Sascha ; Schäfers, Hans-Joachim ; Weise, Julius Johannes ; Wagenpfeil, Stefan ; Abdul-Khaliq, Hashim ; Poryo, Martin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p157t-67338a30ee6005be661082667ed8b36f80042b9311e73260137159f6dd7f50a13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Age</topic><topic>Analgesics</topic><topic>Diuretics</topic><topic>Heart surgery</topic><topic>Intensive care</topic><topic>Length of stay</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Regression analysis</topic><topic>Sedatives</topic><topic>Surgery</topic><topic>Vasoactive agents</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Vogt, Antonia</creatorcontrib><creatorcontrib>Meyer, Sascha</creatorcontrib><creatorcontrib>Schäfers, Hans-Joachim</creatorcontrib><creatorcontrib>Weise, Julius Johannes</creatorcontrib><creatorcontrib>Wagenpfeil, Stefan</creatorcontrib><creatorcontrib>Abdul-Khaliq, Hashim</creatorcontrib><creatorcontrib>Poryo, Martin</creatorcontrib><collection>Springer Nature OA/Free Journals</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><jtitle>European journal of pediatrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Vogt, Antonia</au><au>Meyer, Sascha</au><au>Schäfers, Hans-Joachim</au><au>Weise, Julius Johannes</au><au>Wagenpfeil, Stefan</au><au>Abdul-Khaliq, Hashim</au><au>Poryo, Martin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Standardized Treatment andDiagnostic Approach to Reduce Disease burden in the early postoperative phase in children with congenital heart defects—STANDARD study: a pilot randomized controlled trial</atitle><jtitle>European journal of pediatrics</jtitle><stitle>Eur J Pediatr</stitle><date>2023-12-01</date><risdate>2023</risdate><volume>182</volume><issue>12</issue><spage>5325</spage><epage>5340</epage><pages>5325-5340</pages><issn>0340-6199</issn><eissn>1432-1076</eissn><abstract>To explore the effect of a daily goal checklist on pediatric cardiac intensive care unit (PCICU) length of stay (LOS) after congenital heart surgery. This study is a prospective randomized single-center study. Group characteristics were as follows: STANDARD group:
n
= 30, 36.7% female, median age 0.9 years; control group:
n
= 33, 36.4% female, median age 1.1 years. Invasive ventilation time, STAT categories, mean vasoactive-inotropic score (VIS)
24h
, maximal (max.) VIS
24h
, mean VIS
24–48h
, max. VIS
24–48h
, VIS category, number of sedatives, analgesics, diuretics, number of deployed diagnostic modalities, morbidities, and mortality did not differ between both groups. Median PCICU LOS was 96.0 h (STANDARD group) versus 101.5 h (control group) (
p
= 0.63). In the overall cohort, univariate regression analysis identified age at surgery (
b
= −0.02), STAT category (
b
= 18.3), severity of CHD (
b
= 40.6), mean VIS
24h
(
b
= 3.5), max. VIS
24h
(
b
= 2.2), mean VIS
24–48h
(
b
= 6.5), and VIS category (
b
= 13.8) as significant parameters for prolonged PCICU LOS. In multivariate regression analysis, age at surgery (
b
= −0.2), severity of CHD (
b
= 44.0), and mean VIS
24h
(
b
= 6.7) were of significance. Within the STANDARD sub-group, univariate regression analysis determined STAT category (
b
= 32.3), severity of CHD (
b
= 70.0), mean VIS
24h
(
b
= 5.0), mean VIS
24–48h
(
b
= 5.9), number of defined goals (
b
= 2.6), number of achieved goals (
b
= 3.3), number of not achieved goals (
b
= 10.8), and number of unevaluated goals (
b
= 7.0) as significant parameters for prolonged PCICU LOS. Multivariate regression analysis identified the number of defined goals (
b
= 2.5) and the number of unevaluated goals (
b
= −3.0) to be significant parameters.
Conclusion
: The structured realization and recording of daily goals is of advantage in patients following pediatric cardiac surgery by reducing PCICU LOS.
What is known:
• Communication errors are the most frequent reasons for adverse events in intensive care unit patients.
• Improved communication can be achieved by discussion and documentation of the patients’ goals during daily rounds.
What is new:
• In the overall cohort age at surgery, severity of congenital heart defect and mean vasoactive inotropic score within the first 24 hours had significant impact on pediatric cardiac intensive care unit (PCICU) length of stay (LOS).
• In the intervention group, the number of defined goals and the number of unevaluated goals were significant parameters for prolonged PCICU LOS.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><doi>10.1007/s00431-023-05191-x</doi><tpages>16</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0340-6199 |
| ispartof | European journal of pediatrics, 2023-12, Vol.182 (12), p.5325-5340 |
| issn | 0340-6199 1432-1076 |
| language | eng |
| recordid | cdi_proquest_journals_2904771801 |
| source | SpringerNature Journals |
| subjects | Age Analgesics Diuretics Heart surgery Intensive care Length of stay Medicine Medicine & Public Health Patients Pediatrics Regression analysis Sedatives Surgery Vasoactive agents |
| title | Standardized Treatment andDiagnostic Approach to Reduce Disease burden in the early postoperative phase in children with congenital heart defects—STANDARD study: a pilot randomized controlled trial |
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