Vasoactive-Inotropic Score (VIS)
Composite measure of inotropic / vasoactive drug support (Gaies 2010). VIS = dopamine + dobutamine + 100 × (adrenaline + noradrenaline) + 10 × milrinone + 10 000 × vasopressin (µg/kg/min; vasopressin in units/kg/min). Enter 0 for drugs not running. A high maximum VIS after infant cardiac surgery predicts mortality and morbidity.
Score interpretation
Gaies group 1 (maximum VIS < 10 in the first 24 h).
→ Routine post-op ICU care. Wean inotropes as haemodynamics permit.
Gaies group 2.
→ Echocardiography to assess ventricular function; optimise preload, afterload, rhythm, calcium. Consider lactate trend and SvO₂.
Gaies group 3.
→ Echocardiography to assess ventricular function; optimise preload, afterload, rhythm, calcium. Consider lactate trend and SvO₂.
Gaies group 4: maximum VIS ≥ 20 in the first 24 h after infant cardiac surgery was associated with poor outcome (OR 6.5) and death (Gaies 2014).
→ Senior ICU/cardiac review. Mechanical support (IABP, Impella, V-A ECMO) consideration; aggressive correction of metabolic derangement; surgical re-look if ongoing low cardiac output.
Gaies group 5 (maximum VIS ≥ 25).
→ ECMO / VAD pathway activation. Transplant centre liaison if appropriate. Family counselling on prognosis.
Interpretation bands for the VIS. Apply clinical judgement and local guidance.
References
- Gaies MG, et al. Vasoactive-inotropic score as a predictor of morbidity and mortality in infants after cardiopulmonary bypass. Pediatr Crit Care Med. 2010;11(2):234–238.
- Gaies MG, et al. Vasoactive-inotropic score is associated with outcome after infant cardiac surgery: an analysis from the Pediatric Cardiac Critical Care Consortium and Virtual PICU System Registries. Pediatr Crit Care Med. 2014;15(6):529–537.
Related
Curated clinical cross-links plus same-class fallbacks.
- Lidocaine IV (Cardiac Arrhythmia) · Antiarrhythmic
- Protamine Sulphate (Heparin Reversal) · Heparin Reversal / Cardiac Surgery
- Mavacamten · Cardiac myosin inhibitor
- Folinic Acid (Calcium Folinate / Leucovorin) · Antidote / Chemotherapy Support
- Melatonin · Melatonin Receptor Agonist
- Enteral feeds · Nutritional support
- Rapid Sequence Induction (RSI) · DAS 2015 / AAGBI
- ICU Sedation and Analgesia · SCCM / NICE CG83
- Vasopressor Escalation in Shock · Surviving Sepsis Campaign 2021
- Tracheostomy Management · NTSP / ICS guidelines
- Otitis Media with Effusion (Glue Ear) · NICE NG176 (2021)
- Febrile Child Assessment (Traffic Light) · NICE CG160 2013
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.