REAL-TIME PREDICTION OF ACUTE ARREST IN INFANTS WITH SINGLE VENTRICLE PHYSIOLOGY

Doctor's Name: 
Rusin, Carl, BSE, PhD
Hospital/Institution: 
Baylor University, Houston, TX

Collaboratively awarded through the CHF and AHA Congenital Heart Defect Research Awards

(Total Grant Award: $140,000; CHF's Portion $70,000)

Children with single ventricle congenital heart lesions account for 25-40% of all neonatal cardiac deaths. Between 35-50% of these kids will experience an unanticipated acute cardio-respiratory arrest event within the first 3 months of life, and 15% will expire over this same time period. This study addresses the current inability to accurately detect the onset of acute cardio-respiratory arrest events in this population. We intend to validate a system which provides a 1-2 hour early warning notice to care team members of an imminent arrest, which would allow them to proactively respond to mitigate arrest events before they become life threatening, decreasing mortality and morbidity of these children.

We have developed an algorithm which can continuously assess the chance of a cardio-respiratory arrest event occurring in the next 1-2 hours in single ventricle children. Our study questions are simple: 1) How well does this algorithm work?, 2) Can we improve the algorithm by using additional types of physiologic measurements? 3) How is the indication of risk generated by the algorithm related to other post-surgical outcomes? We intend to answer these questions by collecting a large independent cohort of subjects at Texas Children's Hospital (the largest children's hospital in the world), use this cohort to validate the algorithm and measure its performance, and correlate the results of the algorithm with patient outcomes.

 

This study directly impacts the mission of the AHA by creating a new clinical diagnostic tool which can be used to help prevent life-threatening cardio-respiratory arrest events in children with congenital heart defects. The predictive algorithm described in this study represents a fundamental shift in the way that these critically ill patients are monitored: a shift from reactive care to proactive care. We know that the sooner an intervention can be applied, the larger its protective effect. This translates into decreased length of stay, lower mortality and morbidity, as well as reduced cost of care for these children. The technologies and methodologies developed by this study are immediately applicable to other cardiac populations, both in the pediatric as well as adult populations.

Award Date 1: 
2016
Award Amount 1: 
$70,000