Evidence map›Paper›PMID 41201594›Full record

Observational studyPediatric cardiology2026

Opioid and Methadone Prescribing for Infants with Surgical Management of Congenital Heart Disease.

Rabab M Barq, Shadassa Ourshalimian, Olivia A Keane, Ashwini Lakshmanan, Cynthia S Herrington, Lara P Nelson, Henry C Lee, Susan R Hintz, Nam Nguyen, Malia Szyman and 1 more

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Pediatric cardiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Rabab M BarqDivision of Pediatric Surgery, Children's Hospital Los Angeles, 4650 Sunset Blvd, Mailstop #100, Los Angeles, CA, 90027, USA. rbarq@chla.usc.edu.
Shadassa OurshalimianDivision of Pediatric Surgery, Children's Hospital Los Angeles, 4650 Sunset Blvd, Mailstop #100, Los Angeles, CA, 90027, USA.
Olivia A KeaneDivision of Pediatric Surgery, Children's Hospital Los Angeles, 4650 Sunset Blvd, Mailstop #100, Los Angeles, CA, 90027, USA.
Ashwini LakshmananDivision of Neonatology, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA.
Cynthia S HerringtonDivision of Cardiothoracic Surgery, Department of Surgery, University of Southern California, Los Angeles, CA, USA.
Lara P NelsonDivision of Neonatology, Department of Pediatrics, Children's Hospital Los Angeles, Fetal and Neonatal Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Henry C LeeDivision of Neonatology, University of California San Diego, La Jolla, CA, USA.
Susan R HintzDivision of Neonatology, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA.
Nam NguyenDivision of Pediatric Surgery, Children's Hospital Los Angeles, 4650 Sunset Blvd, Mailstop #100, Los Angeles, CA, 90027, USA.
Malia SzymanDepartment of Health Systems Science, Bernard J. Tyson Kaiser Permanente School of Medicine, Pasadena, CA, USA.
Lorraine I Kelley-QuonDivision of Pediatric Surgery, Children's Hospital Los Angeles, 4650 Sunset Blvd, Mailstop #100, Los Angeles, CA, 90027, USA.

Funding

The Impact of Opioids on Health Outcomes for Hospitalized InfantsR01HD105656 · NICHD · CHILDREN'S HOSPITAL OF LOS ANGELES · PI Lorraine I Kelley-Quon · 2022 to 2026
$3.1M
NICHD NIH HHS R01 HD105656NIH HHS R01HD105656
6 · The paper itself

Abstract

Opioids are commonly prescribed for infants after congenital heart disease (CHD) surgery, and prolonged exposure can lead to physiologic dependence requiring methadone treatment. The Risk Adjustment for Congenital Heart Surgery-2 (RACHS-2) categorizes operative mortality risk and may also help identify infants at greatest risk for methadone treatment. A retrospective cohort study of infants < 1 year undergoing CHD surgery between 2016-2022 at 48 U.S. children's hospitals using the Pediatric Health Information System was performed. Infants were categorized by RACHS-2 score (1 = lowest, 5 = highest risk). Multivariable hierarchical logistic regression evaluated associations between postoperative opioid days and methadone treatment, including an interaction between RACHS-2 and opioid exposure. Secondary analyses compared postoperative length of stay (LOS), ventilator days, and total parenteral nutrition (TPN) days by methadone status. Among 34,127 infants, higher RACHS-2 scores were associated with longer postoperative opioid exposure (p < 0.001). For infants who received < 17 days of opioids, increasing RACHS-2 scores predicted greater probability of methadone treatment. After 17 days, RACHS-2 score 1 infants had the highest probability of methadone treatment, though they represented a minority. Methadone was independently associated with longer LOS, ventilator days, and TPN days. Higher RACHS-2 scores were associated with increased likelihood of postoperative methadone treatment in the early postoperative period. Methadone treatment was associated with adverse short-term health outcomes. For infants with prolonged opioid exposure, those with lower RACHS-2 scores were more likely receive methadone treatment- highlighting subpopulations that may benefit from targeted opioid stewardship initiatives.

Indexed as

Analgesics, OpioidCardiac Surgical ProceduresHeart Defects, CongenitalMethadonePostoperative PainFemaleHumansInfantInfant, NewbornLength of StayMaleRetrospective StudiesUnited StatesAnalgesics, OpioidMethadoneCongenital heart diseaseInfantsOpioidsPainPharmacologyRACHS-2

Identifiers

PMID41201594
PMCPMC12882785

What OpenQuestion holds

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LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.