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y la de ventilaci&#243;n mec&#225;nica &#40;VM&#41;&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Se realiz&#243; un estudio observacional retrospectivo unic&#233;ntrico&#44; aprobado por el Comit&#233; de &#201;tica local&#44; en el que se incluyeron 65 ni&#241;os &#40;edad mediana de 57 meses&#41; que ingresaron en la UCIP tras un TC entre 2003 y 2014&#46; Se calcularon las peores puntuaciones de gravedad cl&#237;nica y FMO&#44; <span class="elsevierStyleItalic">Pediatric Logistic Organ Dysfunction</span> &#40;PELOD&#41;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> y <span class="elsevierStyleItalic">Pediatric Multiple Organ Dysfunction Score</span> &#40;PMODS&#41;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a>&#44; <span class="elsevierStyleItalic">Pediatric Risk of Mortality</span> III &#40;PRISM III&#41;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a>&#44; <span class="elsevierStyleItalic">Pediatric Index of Mortality</span> 2 &#40;PIM2&#41;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> en las primeras 48<span class="elsevierStyleHsp" style=""></span>h postrasplante&#46; Se calcul&#243; el valor del II<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>dopamina<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>dobutamina<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>100<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>adrenalina<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>100<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>noradrenalina<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>milrinona &#40;todas en &#956;g&#47;kg&#47;min&#41;<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>10&#46;000<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>vasopresina &#40;mU&#47;kg&#47;min&#41;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">3&#44;4</span></a>&#46; Se analiz&#243; la relaci&#243;n de las puntuaciones con la mortalidad en la UCIP y la duraci&#243;n de ingreso en la UCIP y la de VM&#46; Para el estudio estad&#237;stico se utilizaron el test del &#967;<span class="elsevierStyleSup">2</span> o el test de Fisher&#44; la U de Mann-Whitney y la rho de Spearman&#46; Se consider&#243; significativa una p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">El 50&#44;8&#37; presentaban una cardiopat&#237;a cong&#233;nita&#44; el 47&#44;7&#37; una miocardiopat&#237;a y el 4&#44;6&#37; un tumor mioc&#225;rdico&#46; La puntuaci&#243;n PRISM III fue del 12&#44;6&#37; &#40;P25-P75&#58; 3&#44;5-25&#44;9&#41;&#44; PIM 2 19&#37; &#40;P25-P75&#58; 3&#44;4-27&#44;8&#41;&#44; PELOD 11 &#40;P25-P75&#58; 2-13&#41; y PMODS 5 &#40;P25-P75&#58; 3-8&#41;&#46; El II fue de 22 &#40;P25-P75&#58; 15-36&#41;&#46; Existi&#243; una correlaci&#243;n moderada entre el II y las puntuaciones de PRISM III &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;260&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;036&#41;&#44; PELOD &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;370&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;003&#41;&#44; PMODS &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;300&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;002&#41; pero no con el PIM2 &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;300&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;120&#41;&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Fallecieron 4 pacientes &#40;6&#44;2&#37;&#41; durante el ingreso en la UCIP&#44; solo uno por FMO&#46; No existi&#243; relaci&#243;n entre las puntuaciones de FMO y de gravedad cl&#237;nicas con la mortalidad &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46; El II fue significativamente m&#225;s elevado en los ni&#241;os fallecidos &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46; Las diferencias de mortalidad entre los ni&#241;os con II<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>15 &#40;8&#44;1&#37;&#41; y<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>15 &#40;0&#37;&#41; no fueron significativas &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;565&#41;&#46; Los ni&#241;os que fallecieron precisaron con mayor frecuencia ECMO y t&#233;cnica de depuraci&#243;n extrarrenal &#40;TDER&#41; que los supervivientes&#44; pero las diferencias solo fueron estad&#237;sticamente significativas con la TDER &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46; Existi&#243; una correlaci&#243;n moderada entre el II&#44; y las puntuaciones de gravedad y FMO &#40;excepto el PELOD&#41; con la duraci&#243;n del ingreso en la UCIP y de VM &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#41;&#46; Los pacientes con un II mayor de 15 tras el TC presentaron una mayor duraci&#243;n de ingreso en la UCIP&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Nuestro estudio es el primero que ha estudiado el FMO en el TC en ni&#241;os&#46; En nuestro estudio las puntuaciones de FMO fueron elevadas&#44; aunque la mortalidad fue baja &#40;6&#44;1&#37;&#41; similar a la referida previamente<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2&#44;4&#44;5</span></a>&#46; No hemos encontrado una relaci&#243;n significativa entre el FMO y la mortalidad&#44; aunque el hecho de que solo fallecieron 4 pacientes limita la comparaci&#243;n estad&#237;stica&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">En ni&#241;os tras cirug&#237;a cardiaca se ha encontrado relaci&#243;n entre los valores elevados de II y una mayor mortalidad<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">3&#44;4</span></a>&#46; Sanil y Aggarwal encontraron que un II<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>15 se asoci&#243; con mayor mortalidad en 51 ni&#241;os tras TC<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a>&#46; En nuestro estudio los pacientes que fallecieron ten&#237;an un II significativamente m&#225;s elevado que los supervivientes&#44; y todos los fallecidos presentaban un II<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>15&#44; apoyando el valor pron&#243;stico del II tras el TC en ni&#241;os&#46; Sin embargo&#44; el valor del II fue significativamente mayor que el encontrado por Sanil y Aggarwal<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a>&#46; Por otra parte&#44; hay que tener en cuenta que en los ni&#241;os con ECMO el II puede no valorar adecuadamente la gravedad cl&#237;nica ya que pueden requerir menor dosis de f&#225;rmacos vasoactivos&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Los ni&#241;os sometidos a TC con un II mayor de 15 presentaron una mayor duraci&#243;n del ingreso en la UCIP coincidiendo con lo referido por Sanil y Aggarwal<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a>&#46; La correlaci&#243;n entre el II y la duraci&#243;n de ingreso en la UCIP fue moderada&#46; Tambi&#233;n existi&#243; una correlaci&#243;n moderada entre las puntuaciones de gravedad y FMO con la duraci&#243;n de ingreso&#46; Sin embargo&#44; no parece que las puntuaciones de gravedad cl&#237;nica y las de FMO en las primeras 48<span class="elsevierStyleHsp" style=""></span>h tras el TC puedan tener un importante valor de predicci&#243;n de la duraci&#243;n de ingreso en la UCIP y de VM en los ni&#241;os con TC&#44; aunque son necesarios estudios m&#225;s amplios que lo analicen&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Por el contrario&#44; nuestros datos&#44; al igual que otros trabajos&#44; muestran que la necesidad de ECMO y TDER tras el trasplante se relaciona claramente con una significativa mayor duraci&#243;n del tiempo de ingreso en la UCIP<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">3&#44;4&#44;10</span></a>&#44; lo que sugiere que la necesidad de estas t&#233;cnicas es un importante marcador pron&#243;stico&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">La principal limitaci&#243;n de nuestro estudio es su car&#225;cter retrospectivo&#44; unic&#233;ntrico y de larga duraci&#243;n&#44; y aunque es una serie amplia&#44; el n&#250;mero de fallecidos es demasiado bajo para analizar adecuadamente la mortalidad con un estudio multivariante&#46; Adem&#225;s&#44; las puntuaciones de gravedad cl&#237;nica y de FMO pueden verse artefactadas en los pacientes tratados con ECMO y TDER&#44; ya que dan valores falsamente bajos&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Concluimos que los ni&#241;os presentan en el periodo postoperatorio del TC valores elevados en las puntuaciones de FMO y un elevado n&#250;mero de complicaciones&#44; pero una mortalidad relativamente baja&#46; El II puede ser un indicador pron&#243;stico de mortalidad y de ingreso en la UCIP&#46; Las puntuaciones de FMO se correlacionan moderadamente con la duraci&#243;n de ingreso y de VM&#44; pero no con la mortalidad&#46; Son necesarios estudios amplios multic&#233;ntricos que analicen la repercusi&#243;n del FMO en la evoluci&#243;n del TC en los ni&#241;os con TC&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Autor&#237;as</span><p id="par0055" class="elsevierStylePara elsevierViewall">Dise&#241;o del estudio&#44; an&#225;lisis estad&#237;stico&#44; interpretaci&#243;n de los datos y redacci&#243;n del manuscrito&#58; Jorge L&#243;pez&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Recogida de datos&#44; interpretaci&#243;n de los datos y redacci&#243;n del manuscrito&#58; Mar&#237;a Sl&#246;cker&#44; Elena Heras&#44; Daniela R&#237;os&#44; Laura Barrio&#44; Rosal&#237;a Cebri&#225;n y D&#233;bora G&#243;mez&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Dise&#241;o del estudio&#44; interpretaci&#243;n de los datos&#44; redacci&#243;n del manuscrito y supervisi&#243;n del estudio&#58; Jes&#250;s L&#243;pez-Herce&#46;</p></span></span>"
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          "leyenda" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Los valores se presentan como medianas y P25-P75 o como valor absoluto y porcentaje&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">ECMO&#58; oxigenaci&#243;n por membrana extracorp&#243;rea&#59; PELOD&#58; Pediatric Logistic Organ Dysfunction&#59; PIM2&#58; Pediatric Index of Mortality 2&#59; PMODS&#58; Pediatric Multiple Organ Dysfunction Score&#59; PRISM III&#58; Pediatric Risk of Mortality III&#59; TDER&#58; t&#233;cnica de depuraci&#243;n extrarrenal continua&#46;</p>"
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Supervivientes&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">61&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">PIM &#40;riesgo de mortalidad&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">19 &#40;13&#44;4-28&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">18&#44;8 &#40;11&#44;6-22&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">0&#44;683&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">PRIMS &#40;riesgo de mortalidad&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">11&#44;6 &#40;3&#44;3-25&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">40&#44;1 &#40;13&#44;6-49&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">11 &#40;2-13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">13&#44;5 &#40;11&#44;5-27&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;064&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t">5 &#40;2&#44;5-8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">7 &#40;6&#44;2-7&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;203&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">&#205;ndice inotr&#243;pico&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">22 &#40;15-36&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">56 &#40;33-74&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;006&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">ECMO &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">9 &#40;14&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;50&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;130&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">TDER &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">13 &#40;21&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t" scope="col">24-48<span class="elsevierStyleHsp" style=""></span>h&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Duraci&#243;n de ingreso&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col">Valor de p&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Duraci&#243;n de la ventilaci&#243;n mec&#225;nica&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col">Valor de p&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Correlaci&#243;n &#40;r&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Correlaci&#243;n &#40;r&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PIM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;389&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;392&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PRIMS&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;437&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PELOD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;207&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;098&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;403&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PMODS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;268&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;031&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;336&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#205;ndice inotr&#243;pico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;300&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;362&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">D&#237;as&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">D&#237;as&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">ECMO</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31 &#40;20-90&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;025</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19 &#40;11-53&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;002</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#44;5 &#40;10-36&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;1&#44;7-15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">TDER</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34 &#40;21&#44;5-82&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;002</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26 &#40;11&#44;5-51&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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Utilidad pronóstica de las puntuaciones de fallo multiorgánico y del índice inotrópico en el postoperatorio de trasplante cardiaco en niños
Prognostic utility of the multiorgan failure scores and inotropic index in the postoperative of cardiac transplantation in children
J. Lópeza,c,d, M. Slöckera,c, E. Herasa,c, D. Ríosb, L. Barriob, R. Cebriánb, D. Gómezb, J. López-Hercea,b,c,d,
Autor para correspondencia
pielvi@hotmail.com

Autor para correspondencia.
a Servicio de Cuidados Intensivos Pediátricos, Hospital General Universitario Gregorio Marañón, Madrid, España
b Departamento de Pediatría, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España
c Instituto de Investigación Sanitaria, Hospital Gregorio Marañón, Madrid, España
d Red de Salud Maternoinfantil y del Desarrollo (red SAMID), Instituto de Salud Carlos III, Madrid, España
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Se analiz&#243; la relaci&#243;n de las puntuaciones con la mortalidad en la UCIP y la duraci&#243;n de ingreso en la UCIP y la de VM&#46; Para el estudio estad&#237;stico se utilizaron el test del &#967;<span class="elsevierStyleSup">2</span> o el test de Fisher&#44; la U de Mann-Whitney y la rho de Spearman&#46; Se consider&#243; significativa una p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">El 50&#44;8&#37; presentaban una cardiopat&#237;a cong&#233;nita&#44; el 47&#44;7&#37; una miocardiopat&#237;a y el 4&#44;6&#37; un tumor mioc&#225;rdico&#46; La puntuaci&#243;n PRISM III fue del 12&#44;6&#37; &#40;P25-P75&#58; 3&#44;5-25&#44;9&#41;&#44; PIM 2 19&#37; &#40;P25-P75&#58; 3&#44;4-27&#44;8&#41;&#44; PELOD 11 &#40;P25-P75&#58; 2-13&#41; y PMODS 5 &#40;P25-P75&#58; 3-8&#41;&#46; El II fue de 22 &#40;P25-P75&#58; 15-36&#41;&#46; Existi&#243; una correlaci&#243;n moderada entre el II y las puntuaciones de PRISM III &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;260&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;036&#41;&#44; PELOD &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;370&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;003&#41;&#44; PMODS &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;300&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;002&#41; pero no con el PIM2 &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;300&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;120&#41;&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Fallecieron 4 pacientes &#40;6&#44;2&#37;&#41; durante el ingreso en la UCIP&#44; solo uno por FMO&#46; No existi&#243; relaci&#243;n entre las puntuaciones de FMO y de gravedad cl&#237;nicas con la mortalidad &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46; El II fue significativamente m&#225;s elevado en los ni&#241;os fallecidos &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46; Las diferencias de mortalidad entre los ni&#241;os con II<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>15 &#40;8&#44;1&#37;&#41; y<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>15 &#40;0&#37;&#41; no fueron significativas &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;565&#41;&#46; Los ni&#241;os que fallecieron precisaron con mayor frecuencia ECMO y t&#233;cnica de depuraci&#243;n extrarrenal &#40;TDER&#41; que los supervivientes&#44; pero las diferencias solo fueron estad&#237;sticamente significativas con la TDER &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46; Existi&#243; una correlaci&#243;n moderada entre el II&#44; y las puntuaciones de gravedad y FMO &#40;excepto el PELOD&#41; con la duraci&#243;n del ingreso en la UCIP y de VM &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#41;&#46; Los pacientes con un II mayor de 15 tras el TC presentaron una mayor duraci&#243;n de ingreso en la UCIP&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Nuestro estudio es el primero que ha estudiado el FMO en el TC en ni&#241;os&#46; En nuestro estudio las puntuaciones de FMO fueron elevadas&#44; aunque la mortalidad fue baja &#40;6&#44;1&#37;&#41; similar a la referida previamente<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2&#44;4&#44;5</span></a>&#46; No hemos encontrado una relaci&#243;n significativa entre el FMO y la mortalidad&#44; aunque el hecho de que solo fallecieron 4 pacientes limita la comparaci&#243;n estad&#237;stica&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">En ni&#241;os tras cirug&#237;a cardiaca se ha encontrado relaci&#243;n entre los valores elevados de II y una mayor mortalidad<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">3&#44;4</span></a>&#46; Sanil y Aggarwal encontraron que un II<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>15 se asoci&#243; con mayor mortalidad en 51 ni&#241;os tras TC<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a>&#46; En nuestro estudio los pacientes que fallecieron ten&#237;an un II significativamente m&#225;s elevado que los supervivientes&#44; y todos los fallecidos presentaban un II<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>15&#44; apoyando el valor pron&#243;stico del II tras el TC en ni&#241;os&#46; Sin embargo&#44; el valor del II fue significativamente mayor que el encontrado por Sanil y Aggarwal<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a>&#46; Por otra parte&#44; hay que tener en cuenta que en los ni&#241;os con ECMO el II puede no valorar adecuadamente la gravedad cl&#237;nica ya que pueden requerir menor dosis de f&#225;rmacos vasoactivos&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Los ni&#241;os sometidos a TC con un II mayor de 15 presentaron una mayor duraci&#243;n del ingreso en la UCIP coincidiendo con lo referido por Sanil y Aggarwal<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a>&#46; La correlaci&#243;n entre el II y la duraci&#243;n de ingreso en la UCIP fue moderada&#46; Tambi&#233;n existi&#243; una correlaci&#243;n moderada entre las puntuaciones de gravedad y FMO con la duraci&#243;n de ingreso&#46; Sin embargo&#44; no parece que las puntuaciones de gravedad cl&#237;nica y las de FMO en las primeras 48<span class="elsevierStyleHsp" style=""></span>h tras el TC puedan tener un importante valor de predicci&#243;n de la duraci&#243;n de ingreso en la UCIP y de VM en los ni&#241;os con TC&#44; aunque son necesarios estudios m&#225;s amplios que lo analicen&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Por el contrario&#44; nuestros datos&#44; al igual que otros trabajos&#44; muestran que la necesidad de ECMO y TDER tras el trasplante se relaciona claramente con una significativa mayor duraci&#243;n del tiempo de ingreso en la UCIP<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">3&#44;4&#44;10</span></a>&#44; lo que sugiere que la necesidad de estas t&#233;cnicas es un importante marcador pron&#243;stico&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">La principal limitaci&#243;n de nuestro estudio es su car&#225;cter retrospectivo&#44; unic&#233;ntrico y de larga duraci&#243;n&#44; y aunque es una serie amplia&#44; el n&#250;mero de fallecidos es demasiado bajo para analizar adecuadamente la mortalidad con un estudio multivariante&#46; Adem&#225;s&#44; las puntuaciones de gravedad cl&#237;nica y de FMO pueden verse artefactadas en los pacientes tratados con ECMO y TDER&#44; ya que dan valores falsamente bajos&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Concluimos que los ni&#241;os presentan en el periodo postoperatorio del TC valores elevados en las puntuaciones de FMO y un elevado n&#250;mero de complicaciones&#44; pero una mortalidad relativamente baja&#46; El II puede ser un indicador pron&#243;stico de mortalidad y de ingreso en la UCIP&#46; Las puntuaciones de FMO se correlacionan moderadamente con la duraci&#243;n de ingreso y de VM&#44; pero no con la mortalidad&#46; Son necesarios estudios amplios multic&#233;ntricos que analicen la repercusi&#243;n del FMO en la evoluci&#243;n del TC en los ni&#241;os con TC&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Autor&#237;as</span><p id="par0055" class="elsevierStylePara elsevierViewall">Dise&#241;o del estudio&#44; an&#225;lisis estad&#237;stico&#44; interpretaci&#243;n de los datos y redacci&#243;n del manuscrito&#58; Jorge L&#243;pez&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Recogida de datos&#44; interpretaci&#243;n de los datos y redacci&#243;n del manuscrito&#58; Mar&#237;a Sl&#246;cker&#44; Elena Heras&#44; Daniela R&#237;os&#44; Laura Barrio&#44; Rosal&#237;a Cebri&#225;n y D&#233;bora G&#243;mez&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Dise&#241;o del estudio&#44; interpretaci&#243;n de los datos&#44; redacci&#243;n del manuscrito y supervisi&#243;n del estudio&#58; Jes&#250;s L&#243;pez-Herce&#46;</p></span></span>"
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          "leyenda" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Los valores se presentan como medianas y P25-P75 o como valor absoluto y porcentaje&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">ECMO&#58; oxigenaci&#243;n por membrana extracorp&#243;rea&#59; PELOD&#58; Pediatric Logistic Organ Dysfunction&#59; PIM2&#58; Pediatric Index of Mortality 2&#59; PMODS&#58; Pediatric Multiple Organ Dysfunction Score&#59; PRISM III&#58; Pediatric Risk of Mortality III&#59; TDER&#58; t&#233;cnica de depuraci&#243;n extrarrenal continua&#46;</p>"
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          "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Relaci&#243;n de la mortalidad con las puntuaciones de gravedad y de fallo multiorg&#225;nico&#44; el &#237;ndice inotr&#243;pico y la necesidad de ECMO y TDER en las primeras 48h tras el trasplante cardiaco</p>"
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          "leyenda" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Los valores se presentan en medianas y P25-P75&#46;</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">ECMO&#58; oxigenaci&#243;n por membrana extracorp&#243;rea&#59; PELOD&#58; Pediatric Logistic Organ Dysfunction&#59; PIM2&#58; Pediatric Index of Mortality 2&#59; PMODS&#58; Pediatric Multiple Organ Dysfunction Score&#59; PRISM III&#58; Pediatric Risk of Mortality III&#59; TDER&#58; t&#233;cnica de depuraci&#243;n extrarrenal continua&#46;</p>"
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            0 => array:2 [
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t" scope="col">24-48<span class="elsevierStyleHsp" style=""></span>h&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col">Duraci&#243;n de ingreso&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col">Duraci&#243;n de la ventilaci&#243;n mec&#225;nica&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Correlaci&#243;n &#40;r&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Correlaci&#243;n &#40;r&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">0&#44;389&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;392&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">PRIMS&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;437&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PELOD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;207&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;098&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;403&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PMODS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;268&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;336&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#205;ndice inotr&#243;pico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;300&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;362&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">D&#237;as&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">D&#237;as&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">ECMO</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31 &#40;20-90&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;025</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19 &#40;11-53&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;1&#44;7-15&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34 &#40;21&#44;5-82&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;002</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26 &#40;11&#44;5-51&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#44;5 &#40;10-32&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;1-12&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">&#205;ndice inotr&#243;pico</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23 &#40;12-49&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;006</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;4-16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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ISSN: 02105691
Idioma original: Español
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