Präoperative Azidose und Entwicklung von Säuglingen nach Operation angeborener Herzfehler Preoperative acidosis and infant development following surgery for congenital heart disease.

OBJECTIVE: Prenatal diagnosis has been shown to decrease pre-operative acidosis and might prevent the occurrence of disturbed developmental outcome. The aim of this study is to evaluate parameters for acidosis and their predictive value on developmental outcome in newborns with congenital heart disease. METHODS: A total of 117 patients requiring surgery for structural heart disease in the first 31 days of life were included. Diagnosis was established either pre- or postnatally. Preoperative values of lactate, pH and base excess levels were compared to the occurrence of disturbed developmental outcome, i.e. an underperformance of more than 10% on the P90 of a standardized Dutch developmental scale. Patients were divided into groups according to blood levels of acidosis parameters, using receiver operating characteristics curves to determine cut-off values for pH, base excess and lactate. RESULTS: No significant difference in developmental outcome was found using values for pH or base excess as a cut-off level. Preoperative lactate values exceeding 6.1 mmol/l resulted in a significant increase in impaired development compared to infants with a pre-operative lactate lower than 6.1 mmol/l: 40.9% vs 15.1% in (p=0.03). CONCLUSIONS: Pre-operative lactate values might have a prognostic value on developmental outcome in newborns with congenital heart disease. The limited prognostic value of pH can be explained by the fact that pH can be easily corrected, while lactate better reflects the total oxygen debt experienced by these patients.

Report on the Grow Iowa Values Fund (GIVF) for the period July 1, 2003 through June 30, 2006.

Report on the Grow Iowa Values Fund (GIVF) for the period July 1, 2003 through June 30, 2006.

Audit report on a review of selected general and application controls over the University of Northern Iowa’s Modern Executive Management Financial Information System (MEMFIS) human resources and payroll modules for the period May 22, 2006 through June 12, 2006.

Audit report on a review of selected general and application controls over the University of Northern Iowa’s Modern Executive Management Financial Information System (MEMFIS) human resources and payroll modules for the period May 22, 2006 through June 12, 2006.

Report on a review of selected general and application controls over the Iowa Department of Transportation’s Resource Management System for the period May 5, 2006 through August 4, 2006.

Report on a review of selected general and application controls over the Iowa Department of Transportation’s Resource Management System for the period May 5, 2006 through August 4, 2006.

Report on a special investigation of programs administered by the Central Iowa Employment and Training Consortium (CIETC) and Iowa Workforce Development (IWD) for the period July 1, 2003 through December 15, 2005

Report on a special investigation of programs administered by the Central Iowa Employment and Training Consortium (CIETC) and Iowa Workforce Development (IWD) for the period July 1, 2003 through December 15, 2005

Special investigation of the Washington Community School District for the period June 1, 2003 through October 31, 2006

Special investigation of the Washington Community School District for the period June 1, 2003 through October 31, 2006

Audit report on a special investigation of the Bear Creek Narcotics Task Force for the period July 1, 2003 through November 30, 2006

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Audit report on applying agreed-upon procedures for the City of Linden’s compliance with road use tax requirements for the period July 1, 1999 through June 30, 2004

Audit report on applying agreed-upon procedures for the City of Linden’s compliance with road use tax requirements for the period July 1, 1999 through June 30, 2004

Report on a special investigation of the Dallas County Jail for the period July 31, 2000 through February 5, 2007

Report on a special investigation of the Dallas County Jail for the period July 31, 2000 through February 5, 2007

Special investigation of the Crawford County Conservation Department for the period January 25, 2002 through December 7, 2006

Special investigation of the Crawford County Conservation Department for the period January 25, 2002 through December 7, 2006

Special investigation of the City of McCausland for the period January 1, 1999 through January 31, 2007

Special investigation of the City of McCausland for the period January 1, 1999 through January 31, 2007

Agreed upon procedures report on the City of Emerson, Iowa for the period July 1, 2005 through June 30, 2006

Agreed upon procedures report on the City of Emerson, Iowa for the period July 1, 2005 through June 30, 2006

Report on a special investigation of Three Rivers Independent Living Corporation for the period July 1, 2005 through May 26, 2006

Report on a special investigation of Three Rivers Independent Living Corporation for the period July 1, 2005 through May 26, 2006

Audit report on the review of selected general and application controls over the State University of Iowa University of Iowa) ProTrav system for the period June 5, 2006 through July 28, 2006

Audit report on the review of selected general and application controls over the State University of Iowa University of Iowa) ProTrav system for the period June 5, 2006 through July 28, 2006

Special investigation of the Dallas County Mental Health Advocate for the period September 1, 2005 through March 31, 2006

Special investigation of the Dallas County Mental Health Advocate for the period September 1, 2005 through March 31, 2006