Zubarioglu et al reported on the use of the Vasoactive-Ventilation-Renal Score for evaluation of a neonate undergoing cardiac surgery. The authors are from Yen Yuzyil University in Istanbul.
Patient selection: neonate following cardiac surgery for congenital heart disease.
Assessment: ICU admission, 24 hours, 48 hours and 72 hours after ICU admission
Parameters:
(1) ventilator respiratory rate per minute
(2) peak inspiratory pressure in cm H2O
(3) positive end-expiratory pressure in cm H2O
(4) PaCO2, units not given, presumed mm Hg
(5) VIS (vasoactive inotrope score)
(6) serum creatinine at baseline
(7) serum creatinine, in mg/dL
(8) body weight in kilograms
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Vasoactive Drug
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Points
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dopamine in µg/kg/min
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|
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dobutamine in µg/kg/min
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|
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epinephrine in µg/kg/min
|
100 *
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milrinone in µg/kg/min
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10 *
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vasopressin in U/kg/min
|
10,000 *
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norepinephrine in µg/kg/min
|
100 *
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VIS =
= SUM(points for all of the vasoactive drugs)
deltta creatinine =
= 10 * ((current serum creatinine) - (baseline serum creatinine))
ventilation index =
= (ventilator respiratory rate) * ((peak inspiratory pressure) - (PEEP)) * (PaCO2) / 1000
vasoactive ventilation renal score = VVR =
= (ventilation index) + (VIS) + (delta creatinine)
Interpretation:
• The VVR at 72 hours and maximum VVR were associated with mortality and ICU length of stay.
